Individual provider Active NPI

Alexis Leigh Coleman, PA

  • Medical Physician Assistant
  • South Boston, VA
National Provider Identifier
1003418302
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2210 Wilborn Ave
South Boston, VA 24592-1630
Phone
(941) 740-1946
NPI assigned
Nov 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

2210 Wilborn Ave
South Boston, VA 24592-1630

Mailing address

203 Hull St Apt 4a
Richmond, VA 23224-4275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210317002194 VA Practitioner - Physician Assistant 7618383696 Reassigns benefits to 4 organizations
I20260423001259 CA Practitioner - Physician Assistant 7618383696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Healthcare Providers LLCGroup PAC ID 1456629369, 264 clinicians
Mary Washington Healthcare PhysiciansGroup PAC ID 2769546530, 286 clinicians
Urgent Specialty Associates PLLCGroup PAC ID 7618235995, 56 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-5610

7101 Jahnke Rd
Richmond, VA 23225-4017
Phone (804) 483-0000

Hospital & facility affiliations

  • Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Fredericksburg PTR Current Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Apr 11, 2022 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Apr 11, 2022 Accepting new patients
Mary Washington Hospital Inc. Past Accepting new patients

Locations

1101 Sam Perry Blvd
Ste 400
Fredericksburg, VA 22401
Phone (540) 741-2865

1201 Sam Perry Blvd
Ste 101
Fredericksburg, VA 22401
Phone (540) 741-4614

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

1101 Sam Perry Blvd
Ste 219
Fredericksburg, VA 22401
Phone (540) 741-2855

101 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 741-3340

Interoperability endpoints

  • Direct secure messaging: acoleman68427@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1003418302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 HULL ST APT 4A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232244275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 WILBORN AVE",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921630",
            "telephone_number": "941-740-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "ALEXIS",
        "middle_name": "LEIGH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.