Individual provider Active NPI

Jennifer Rebecca Coe, D.O.

  • Internal Medicine Physician
  • Lutz, FL
National Provider Identifier
1396937207
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS10937 Issued in FL
Practice address
4211 Vandyke Road
Suite 200
Lutz, FL 33558-8005
Phone
(813) 321-6237
Fax
(813) 463-1801
NPI assigned
Aug 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS10937 FL Primary

Addresses

Primary practice location

4211 Vandyke Road
Suite 200
Lutz, FL 33558-8005

Mailing address

PO Box 10744
Clearwater, FL 33757-8744
Phone (727) 532-0002

Other identifiers 1

IdentifierTypeStateIssuer
002898000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS10937FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1396937207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10744",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337578744",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 VANDYKE ROAD",
            "address_2": "SUITE 200",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588005",
            "telephone_number": "813-321-6237",
            "fax_number": "813-463-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COE",
        "first_name": "JENNIFER",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS10937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002898000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.