Theresa Crocker Coppola, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101057697 Issued in VA

Practice address

650 Peter Jefferson Pkwy
Suite 160
Charlottesville, VA 22911-8844

Phone

(434) 293-3890

Fax

(804) 888-9567

NPI assigned

Aug 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1821000464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 PETER JEFFERSON PKWY",
            "address_2": "SUITE 160",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118844",
            "telephone_number": "434-293-3890",
            "fax_number": "804-888-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 PETER JEFFERSON PKWY",
            "address_2": "SUITE 160",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118844",
            "telephone_number": "434-293-3890",
            "fax_number": "804-888-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "THERESA",
        "middle_name": "CROCKER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101057697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "306350",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "183570",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010171181",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minton Truitt Cooper, M.D.
• Sarah B Cooper, LCSW
• Coordin8 Health
• Andrew P. Copland, M.D.
• Olivia Susanne Coppes, M.S., BCBA
• Eugene C. Corbett Jr., M.D.
• Kayla Boley Corbett, DO, MS
• Michael S Corbett, PA-C
• Sean T. Corbett, M.D.
• William Christopher Corbett, M.D.

• Internal Medicine Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.