Active NPI
Amanda R Coppola, APRN
- Family Nurse Practitioner
- Bridgeport, CT
National Provider Identifier
1609056944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 003696
- Practice address
- 4699 Main St
Bridgeport, CT 06606-1830 - Phone
- (203) 452-8322
- NPI assigned
- Nov 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 003696 | CT | Primary |
Addresses
Primary practice location
4699 Main St
Bridgeport, CT 06606-1830
Mailing address
25 Shelter Rock Rd
Trumbull, CT 06611-3324
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003696 | CT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfield County Healthcare Associates | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Trumbull, CT
- NPI 1235212036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217116800000",
"number": "1609056944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 SHELTER ROCK RD",
"city": "TRUMBULL",
"state": "CT",
"postal_code": "066113324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4699 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066061830",
"telephone_number": "203-452-8322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPPOLA",
"first_name": "AMANDA",
"middle_name": "R",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-04",
"last_updated": "2008-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "003696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.