Lawrence Hayes Coppock, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00420900 Issued in NJ

Practice address

48 N Broadway
Pennsville, NJ 08070-1754

Phone

(856) 678-4800

Fax

(856) 678-3630

NPI assigned

Nov 3, 2005

Last updated

Sep 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Casseys Optical Inc

  • Customized Equipment (DME)
  • Springfield, PA
  • NPI 1427483742
  NPD (past)
• Craig a. Cassey O D P C

  • Optometrist
  • Brookhaven, PA
  • NPI 1598712127
  NPD (past)

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1437140944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 N BROADWAY",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701754",
            "telephone_number": "856-678-4800",
            "fax_number": "856-678-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 N BROADWAY",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701754",
            "telephone_number": "856-678-4800",
            "fax_number": "856-678-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOCK",
        "first_name": "LAWRENCE",
        "middle_name": "HAYES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00420900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "180031090",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2244616000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "223485583",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPERATING ENGINEERS 825",
            "identifier": "65065",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "223485583",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "482523",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clinical@drmazzuca.directbygreenway.com",
            "affiliation": "N",
            "address_1": "48 N Broadway",
            "city": "Pennsville",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080701754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Thaddeaus Chapdelaine, MD
• Christi Erdman, LPC- Coping and Consulting
• Community Dental of Salem, P.C.
• Rona Connelly, LPN
• Cooper Primary Care at Pennsville, PA
• Cornerstone Foot & Ankle
• Corey Cramer, M.D.
• John Brian Cudlipp, O.D.
• Adrienne Davis, LAC
• Ashoke K Deb, MD

• Optometrist in Pennsville, NJ
• Providers in Pennsville, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.