Active NPI
Larry J Coppola, DO
- Family Medicine Physician
- Johnston, IA
National Provider Identifier
1922073022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 02453
- Practice address
- 5731 Greendale Rd
Suite 100
Johnston, IA 50131-1593 - Phone
- (515) 270-1000
- Fax
- (515) 331-6581
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 02453 | IA | Primary |
Addresses
Primary practice location
5731 Greendale Rd
Suite 100
Johnston, IA 50131-1593
Mailing address
5731 Greendale Rd
Suite 100
Johnston, IA 50131-1593
Phone (515) 270-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| I20940052 | Other | IA | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02453 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctorsnow Doral LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Physician
- Johnston, IA
- NPI 1932346079
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447718400000",
"number": "1922073022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5731 GREENDALE RD",
"address_2": "SUITE 100",
"city": "JOHNSTON",
"state": "IA",
"postal_code": "501311593",
"telephone_number": "515-270-1000",
"fax_number": "515-331-6581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5731 GREENDALE RD",
"address_2": "SUITE 100",
"city": "JOHNSTON",
"state": "IA",
"postal_code": "501311593",
"telephone_number": "515-270-1000",
"fax_number": "515-331-6581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPPOLA",
"first_name": "LARRY",
"middle_name": "J",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2015-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "02453",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "I20940052",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnston, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.