Individual provider Active NPI

Sarah Ruth Coughlin, NP

  • Family Nurse Practitioner
  • Rockville, MD
National Provider Identifier
1043761992
Registry record updated Oct 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R210677 Issued in MD
Practice address
7955 Tuckerman LN
Rockville, MD 20854-3243
Phone
(866) 389-2727
NPI assigned
Oct 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R210677 MD Primary

Addresses

Primary practice location

7955 Tuckerman LN
Rockville, MD 20854-3243

Mailing address

4102 Knowles Ave
Kensington, MD 20895-2405
Phone (973) 722-5708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191022001185 WA Practitioner - Nurse Practitioner 5193007532 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R210677MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Specialties PLLC CurrentSince Sep 3, 2019 Accepting new patients

Locations

2920 S Meridian
Ste 100
Puyallup, WA 98373
Phone (253) 604-4599

1624 S I St
Ste 305
Tacoma, WA 98405

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1476576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476576000000",
    "number": "1043761992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 KNOWLES AVE",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952405",
            "telephone_number": "973-722-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7955 TUCKERMAN LN",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208543243",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHLIN",
        "first_name": "SARAH",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-16",
        "last_updated": "2016-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R210677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.