Mary Coppola

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

905500 Issued in MS

Practice address

215 Katherine Drive
Suite a
Flowood, MS 39232-9588

Phone

(601) 665-4162

Fax

(855) 830-3484

NPI assigned

Oct 25, 2022

Last updated

Oct 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minor Med Care, LLCGroup PAC ID 7618866021, 77 clinicians

MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Simpson General Hospital Cah Hospital, Mendenhall, MS, CCN 251317
• Magee General Hospital Hospital, Magee, MS, CCN 250124

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minor Med Care, LLC

  • Primary Care Clinic/Center
  • Jackson, MS
  • NPI 1407968738
  Medicare reassignment Care Compare group NPD
• MDB Care Management LLC

  • Primary Care Nurse Practitioner
  • Flowood, MS
  • NPI 1144925272
  Medicare reassignment NPD
• MDB Behavioral Health Services LLC

  dba Complete Care Rural Health Clinic

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310
  Care Compare group NPD (past)
• Minor Med Care, LLC

  • Rural Health Clinic/Center
  • Raymond, MS
  • NPI 1669575627
  NPD
• Uppal Medical Center LLC

  • Rural Health Clinic/Center
  • Greenville, MS
  • NPI 1558927905
  NPD
• Trustcare Primary Care, LLC

  dba TrustCare Health, LLC

  • Family Medicine Physician
  • Madison, MS
  • NPI 1174078554
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Simpson Community Healthcare, Inc.

  dba Simpson General Hospital

  • Critical Access Hospital
  • Mendenhall, MS
  • NPI 1144339839
  Care Compare affiliation
• South Central Regional Medical Center

  dba Magee General Hospital

  • General Acute Care Hospital
  • Magee, MS
  • NPI 1679553994
  Care Compare affiliation

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1386361871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LAKEVIEW DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564436",
            "telephone_number": "315-200-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 KATHERINE DRIVE",
            "address_2": "SUITE A",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329588",
            "telephone_number": "601-665-4162",
            "fax_number": "855-830-3484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Highway 80 E",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MS",
            "postal_code": "390565122",
            "country_code": "US",
            "telephone_number": "601-708-1480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John W Cook, MD
• Kellie McCarra Cook, PT
• Monica Stewart Cook, RPH
• Chad Edward Cooley, M.D.
• Copac Incorporated
• Corner Clinic Urgent Care LLC
• Cox Dental PA (Bellemeade Family Dental)
• Adraine Marie Cox, FNP
• Kathryn Dooley Cox
• Susan Lynne Cox, LPC-S

• Family Nurse Practitioner in Flowood, MS
• Providers in Flowood, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.