Jade Victoria Coppola, PA-C is a medicare enrolled "Physician Assistant - Medical" in Hartwell, Georgia. Her current practice location is
605 E Franklin St, Hartwell, Georgia. You can reach out to her office (for appointments etc.) via phone at
(706) 376-6200.
Jade Victoria Coppola is licensed to practice in Georgia (license number 9274) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1750859104.
Provider's Profile
Full Name | Jade Victoria Coppola |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 605 E Franklin St, Hartwell, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1750859104
- Provider Enumeration Date: 11/04/2018
- Last Update Date: 07/05/2019
Medicare PECOS Information:
- PECOS PAC ID: 0547599615
- Enrollment ID: I20190916001220
Medical Identifiers
Medical identifiers for Jade Victoria Coppola such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1750859104 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | 9274 (Georgia) | Primary |
363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jade Victoria Coppola is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jade Victoria Coppola, PA-C 17 Carter Run Ct, Simpsonville, SC 29681-6573 Ph: (203) 214-0453 | Jade Victoria Coppola, PA-C 605 E Franklin St, Hartwell, GA 30643-7301 Ph: (706) 376-6200 |
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