Individual provider Active NPI

Thomas Owen Coleman

  • Social Worker
  • Bronx, NY
National Provider Identifier
1043701410
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
050552 Issued in NY
Practice address
4401 Bronx Blvd FL 2
Bronx, NY 10470-1407
Phone
(718) 304-7089
Fax
(718) 304-7067
NPI assigned
May 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 050552 NY Primary

Addresses

Primary practice location

4401 Bronx Blvd FL 2
Bronx, NY 10470-1407

Mailing address

4401 Bronx Blvd FL 2
Bronx, NY 10470-1407
Phone (718) 304-7089

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

State licenses

LicenseStateTypeSpecialty
050552NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1043701410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 BRONX BLVD FL 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701407",
            "telephone_number": "718-304-7089",
            "fax_number": "718-304-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 BRONX BLVD FL 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701407",
            "telephone_number": "718-304-7089",
            "fax_number": "718-304-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "THOMAS",
        "middle_name": "OWEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "050552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.