NPIMap

Organization Active NPI

Coppola Physical Therapy and Fitness Gym LLC

  • Physical Therapy Clinic/Center
  • Candia, NH
National Provider Identifier
1346481561
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2164 Issued in NH
Legal business name
COPPOLA PHYSICAL THERAPY AND FITNESS GYM LLC
Practice address
143 Raymond Rd Unit 8
Candia, NH 03034-2133
Phone
(603) 483-3355
NPI assigned
Mar 18, 2009
Last updated
Jun 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Steven Lawrence GordonNPI 1932287398
Title
Co-Owner, Pta
Phone
(603) 315-9552

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 0740 NH
Physical Therapy Clinic/Center 261QP2000X 2164 NH Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

143 Raymond Rd Unit 8
Candia, NH 03034-2133

Mailing address

143 Raymond Rd Unit 8
Candia, NH 03034-2133
Phone (603) 483-3355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090810000044 NH Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0345393302 Receives reassigned benefits from 28 practitioners
Practice locations: Raymond, NH; Goffstown, NH; Derry, NH; Concord, NH; Candia, NH

National Provider Directory

National Provider Directory

Locations

81 Hall St
Ste 202
Concord, NH 03301
Phone (603) 228-7500

89 S Mast St
Goffstown, NH 03045
Phone 6034100096305

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1346481561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 RAYMOND RD UNIT 8",
            "city": "CANDIA",
            "state": "NH",
            "postal_code": "030342133",
            "telephone_number": "603-483-3355",
            "fax_number": "603-483-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 RAYMOND RD UNIT 8",
            "city": "CANDIA",
            "state": "NH",
            "postal_code": "030342133",
            "telephone_number": "603-483-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPOLA PHYSICAL THERAPY AND FITNESS GYM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "CO-OWNER, PTA",
        "authorized_official_telephone_number": "603-315-9552"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NH",
            "license": "0740",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NH",
            "license": "2164",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Candia, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.