Shoeline Surgical Associates, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

RI6307 Issued in RI

Legal business name

SHOELINE SURGICAL ASSOCIATES, INC.

Practice address

70 Kenyon Ave Unit 325
Wakefield, RI 02879-4253

Phone

(401) 284-4114

Fax

(401) 789-1358

NPI assigned

Sep 15, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Coppe, M.D.

Title

President

Phone

(401) 284-4114

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710083043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 KENYON AVE UNIT 325",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794253",
            "telephone_number": "401-284-4114",
            "fax_number": "401-789-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 KENYON AVE UNIT 325",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794253",
            "telephone_number": "401-284-4114",
            "fax_number": "401-789-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOELINE SURGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COPPE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-284-4114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "RI",
            "license": "RI6307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Wakefield, RI
• Providers in Wakefield, RI by specialty
• Specialist in Rhode Island

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