Organization Active NPI

Coppell Adult Medicine Specialist

  • Internal Medicine Physician
  • Coppell, TX
National Provider Identifier
1962584771
Registry record updated Oct 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K9899 Issued in TX
Legal business name
COPPELL ADULT MEDICINE SPECIALIST
Practice address
722 S Denton Tap Rd
# 190
Coppell, TX 75019
Phone
(972) 393-1200
Fax
(972) 393-1234
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2010

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

Authorized official

Name
Dr. Bina Sharma, MDNPI 1699980417
Title
President
Phone
(972) 393-1200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X K9899 TX Primary

Addresses

Primary practice location

722 S Denton Tap Rd
# 190
Coppell, TX 75019

Mailing address

722 S Denton Tap Rd
# 190
Coppell, TX 75019
Phone (972) 393-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101206000077 TX Part B Supplier - Clinic/Group Practice 8628265568 Receives reassigned benefits from 1 practitioner
Practice locations: Coppell, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286841600000",
    "number": "1962584771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 S DENTON TAP RD",
            "address_2": "# 190",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "75019",
            "telephone_number": "972-393-1200",
            "fax_number": "972-393-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 S DENTON TAP RD",
            "address_2": "# 190",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "75019",
            "telephone_number": "972-393-1200",
            "fax_number": "972-393-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPELL ADULT MEDICINE SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-10-12",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "BINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-393-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K9899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coppell, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.