Individual provider Active NPI

Nicole R Cofer, ARNP

  • Family Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1669456125
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024168302 Issued in VA
Practice address
1300 Diamond Springs Rd
Suite 503
Virginia Beach, VA 23455-3645
Phone
(757) 656-1665
Fax
(757) 690-0285
NPI assigned
Nov 30, 2005
Last updated
Jul 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.06937-NP OH
Family Nurse Practitioner 363LF0000X 0024168302 VA Primary

Addresses

Primary practice location

1300 Diamond Springs Rd
Suite 503
Virginia Beach, VA 23455-3645

Mailing address

1300 Diamond Springs Rd
Suite 503
Virginia Beach, VA 23455-3645
Phone (757) 656-1665

Other identifiers 2

IdentifierTypeStateIssuer
1669456125MedicaidVA
2265883MedicaidOH

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.06937-NPOHMDNurse Practitioner
0024168302VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. Past Accepting new patients
Danielle Gange, NP-C PastSince Nov 30, 2015 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1669456125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 DIAMOND SPRINGS RD",
            "address_2": "SUITE 503",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234553645",
            "telephone_number": "757-656-1665",
            "fax_number": "757-690-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 DIAMOND SPRINGS RD",
            "address_2": "SUITE 503",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234553645",
            "telephone_number": "757-656-1665",
            "fax_number": "757-690-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFER",
        "first_name": "NICOLE",
        "middle_name": "R",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.06937-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669456125",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2265883",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; 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.