Individual provider Active NPI

Lisa M Coffelt, R.PH.

  • Pharmacist
  • Virginia Beach, VA
National Provider Identifier
1962739094
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
36749 Issued in TX
Practice address
5232 Fairfield Shopping Ctr
Virginia Beach, VA 23464-4212
Phone
(757) 495-0898
NPI assigned
Nov 10, 2009
Last updated
Oct 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 36749 TX Primary

Addresses

Primary practice location

5232 Fairfield Shopping Ctr
Virginia Beach, VA 23464-4212

Mailing address

5232 Fairfield Shopping Ctr
Virginia Beach, VA 23464-4212
Phone (757) 495-0898

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
36749TXMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation PastSince Oct 30, 2022 Accepting new patients
Eckerd Corporation PastSince Oct 30, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1962739094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5232 FAIRFIELD SHOPPING CTR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644212",
            "telephone_number": "757-495-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5232 FAIRFIELD SHOPPING CTR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644212",
            "telephone_number": "757-495-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFELT",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "36749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.