Individual provider Active NPI

Andrew A Coppola, MD

  • Family Medicine Physician
  • Fayetteville, AR
National Provider Identifier
1831548270
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-11653 Issued in AR
Practice address
2523 E Huntsville Rd
Fayetteville, AR 72701-7329
Phone
(479) 442-2822
Fax
(479) 582-1754
NPI assigned
Jun 7, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-11653 AR Primary

Addresses

Primary practice location

2523 E Huntsville Rd
Fayetteville, AR 72701-7329

Mailing address

PO Box 1523
Fayetteville, AR 72702-1523
Phone (479) 571-6038

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andrew.coppola@mana.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20190530001208 AR Practitioner - Family Practice 5496098766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Northwest Arkansas, PAGroup PAC ID 3678542073, 102 clinicians

Practice addresses (Care Compare)

2523 E Huntsville Rd
Fayetteville, AR 72701-7329
Phone (479) 442-2822

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Springdale, AR, CCN 047170
  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-11653ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Northwest Arkansas, PA Family Medicine CurrentSince Jun 15, 2019 Accepting new patients
Medical Associates of Northwest Arkansas PA Family Medicine CurrentSince Jun 15, 2019 Accepting new patients
Medical Associates of Northwest Arkansas PA Family Medicine Past Accepting new patients
Medical Associates of Northwest Arkansas PA Family Medicine Past Accepting new patients
Medical Associates of Northwest Arkansas PA Family Medicine Past Accepting new patients

Locations

3344 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 582-7213

2523 E Huntsville Rd
Fayetteville, AR 72701
Phone (479) 442-2822

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1831548270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1523",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021523",
            "telephone_number": "479-571-6038",
            "fax_number": "479-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2523 E HUNTSVILLE RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727017329",
            "telephone_number": "479-442-2822",
            "fax_number": "479-582-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "ANDREW",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-11653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.coppola@mana.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "andrew.coppola@mana.eclinicaldirectplus.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2523 E Huntsville Rd",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727017329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.