Jacqueline Sim Coffey, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1118810 Issued in TX

Practice address

11914 Astoria Blvd Ste 450
Houston, TX 77089-6077

Phone

(281) 484-7619

NPI assigned

Apr 6, 2023

Last updated

May 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jcoffey456201@direct.stlukeshealth.org

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.

• Stephen F. Austin Community Health Center, Inc.

  dba Adoue Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Alvin, TX
  • NPI 1578730818
  Medicare reassignment NPD (past)
• Ar Texas Pediatrics, PLLC

  dba Aseema Raoshan, MD

  • Pediatrics Physician
  • Houston, TX
  • NPI 1619324969
  NPD (past)

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1811682768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 COUNTY ROAD 203",
            "city": "LIVERPOOL",
            "state": "TX",
            "postal_code": "775778920",
            "telephone_number": "281-884-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11914 ASTORIA BLVD STE 450",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770896077",
            "telephone_number": "281-484-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "JACQUELINE",
        "middle_name": "SIM",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1118810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Earl Coffee III, MD
• Amy Coffelt, LPC, NCC, CCF-CANDID
• Rebecca Coffey Alvarez
• C. Edward Coffey, M.D.
• Donna Marie Coffey, MD
• Kaitlyn Marie Coffey, LPC-INTERN
• Katherine Paige Coffey, RBT
• Kristin Marie Coffey, RPH
• Meghan Coffey, RDN, LD, CDCES
• Sydney Coffey, LO

• Pediatric Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.