Individual provider Active NPI

Gabrielle Bobbi Coppola, CNM/NP

  • Women's Health Nurse Practitioner
  • Quincy, MA
National Provider Identifier
1780379305
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
2317033 Issued in MA
Practice address
300 Congress St Ste 102
Quincy, MA 02169-0907
Phone
(617) 479-6636
Fax
(617) 472-9868
NPI assigned
Apr 10, 2023
Last updated
May 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 2317033 MA Primary

Addresses

Primary practice location

300 Congress St Ste 102
Quincy, MA 02169-0907

Mailing address

300 Congress St Ste 102
Quincy, MA 02169-0907
Phone (617) 479-6636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2317033MAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crown Obstetrics & Gynecology P.C. CurrentSince Feb 25, 2024 Accepting new patients
Crown Obstetrics and Gynecology PastSince Feb 25, 2024 Accepting new patients

Locations

300 Congress St
Ste 102
Quincy, MA 02169
Phone (617) 471-1161

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": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1780379305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CONGRESS ST STE 102",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690907",
            "telephone_number": "617-479-6636",
            "fax_number": "617-472-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CONGRESS ST STE 102",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690907",
            "telephone_number": "617-479-6636",
            "fax_number": "617-472-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "GABRIELLE",
        "middle_name": "BOBBI",
        "credential": "CNM/NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "2317033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.