BERETTA CRAFT-COFFMAN P.A.-C NPI 1285601880

NPI Information

  • NPI: 1285601880
  • Provider Name: BERETTA CRAFT-COFFMAN, P.A.-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 125 OAKSIDE CT STE 102
    CANTON, GA
    ZIP 30114
  • Phone: (770) 213-8376

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NPI Details

Beretta Craft-coffman, P.A.-C is a surgical physician assistant in Canton, GA with 34 years of experience. Beretta Craft-coffman, P.A.-C NPI is 1285601880. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

125 OAKSIDE CT STE 102
CANTON, GA
ZIP 30114-498
Phone: (770) 213-8376

The NPI 1285601880 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/2/2006 and was last updated on 6/20/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgicalPA.0004259COLORADONo
2363AS0400XPhysician AssistantSurgicalPA9106348FLORIDANo
3363AS0400XPhysician AssistantSurgicalPA2198NEVADANo
4363AS0400XPhysician AssistantSurgical0010-10058NORTH CAROLINANo
5363AS0400XPhysician AssistantSurgicalPA00325MISSISSIPPINo
6363AS0400XPhysician AssistantSurgical1199SOUTH CAROLINANo
7363AS0400XPhysician AssistantSurgicalPA0659NEVADANo
8363AS0400XPhysician AssistantSurgicalPA0000001672TENNESSEENo
9363AS0400XPhysician AssistantSurgicalPA09999TEXASNo
10363AS0400XPhysician AssistantSurgical0110007147VIRGINIANo
11363AS0400XPhysician AssistantSurgical002366GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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