Active NPI
Coppell Associates in Family Medicine PA
- Family Medicine Physician
- Coppell, TX
National Provider Identifier
1447386966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G6149
- Legal business name
- COPPELL ASSOCIATES IN FAMILY MEDICINE PA
- Practice address
- 848 S Denton Tap Rd
Suite 100
Coppell, TX 75019-4558 - Phone
- (972) 393-5559
- Fax
- (972) 393-5479
- NPI assigned
- Feb 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Danielle Roberts
- Title
- Office Staff
- Phone
- (972) 393-5559
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G6149 | TX | Primary |
| Physician Assistant | 363A00000X | PA02895 | TX |
Addresses
Primary practice location
848 S Denton Tap Rd
Suite 100
Coppell, TX 75019-4558
Mailing address
848 S Denton Tap Rd
Suite 100
Coppell, TX 75019-4558
Phone (972) 393-5559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2070969 | Coppell Associates in Family Medicine | Certificate of waiver | Dec 29, 2027 |
National Provider Directory
National Provider DirectoryLocations
848 S Denton Tap Rd
Ste 100
Coppell, TX 75019
Phone (972) 393-5559
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Coppell, TX
- NPI 1154405595
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1401926400000",
"number": "1447386966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "848 S DENTON TAP RD",
"address_2": "SUITE 100",
"city": "COPPELL",
"state": "TX",
"postal_code": "750194558",
"telephone_number": "972-393-5559",
"fax_number": "972-393-5479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "848 S DENTON TAP RD",
"address_2": "SUITE 100",
"city": "COPPELL",
"state": "TX",
"postal_code": "750194558",
"telephone_number": "972-393-5559",
"fax_number": "972-393-5479"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COPPELL ASSOCIATES IN FAMILY MEDICINE PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-26",
"last_updated": "2014-06-05",
"status": "A",
"authorized_official_last_name": "ROBERTS",
"authorized_official_first_name": "DANIELLE",
"authorized_official_title_or_position": "OFFICE STAFF",
"authorized_official_telephone_number": "972-393-5559"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "TX",
"license": "G6149",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA02895",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coppell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.