NPIMap

Individual provider Active NPI

Antonowsky D Coleman, PSYCHIATRY MD

  • Psychiatry Physician
  • Huntingdon, PA
National Provider Identifier
1063529485
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD482601 Issued in PA
Practice address
1225 Warm Springs Ave
Huntingdon, PA 16652-2350
Phone
(814) 643-8880
NPI assigned
Aug 23, 2006
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 00024899 AL
Psychiatry Physician 2084P0800X MD482601 PA Primary

Addresses

Primary practice location

1225 Warm Springs Ave
Huntingdon, PA 16652-2350

Mailing address

PO Box 21231
200 University Blvd
Tuscaloosa, AL 35402-1231
Phone (205) 759-0904

Other practice location 1

200 University Blvd
Tuscaloosa, AL 35402-1231
Phone (205) 759-0904

Other identifiers 3

IdentifierTypeStateIssuer
1042228050001MedicaidPA
051529652OtherALBC
051556361MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041103000473 AL Practitioner - Psychiatry 2860454626 Reassigns benefits to 3 organizations
Practice locations: Bessemer, AL; Hoover, AL
I20231014000590 PA Practitioner - Psychiatry 2860454626 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Alabama School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J C Blair Memorial HospitalGroup PAC ID 2668378407, 98 clinicians

Practice addresses (Care Compare)

1225 Warm Springs Ave
Huntingdon, PA 16652-2350
Phone (814) 643-8880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00024899ALMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Alabama Dept of Finance CurrentSince Jul 11, 2005 Accepting new patients
Tombigbee Healthcare Authority CurrentSince Jan 20, 2015 Accepting new patients
Integrative Health Services, LLC CurrentSince Nov 2, 2020 Accepting new patients
State of Alabama Dept of Finace CurrentSince Jul 11, 2005 Accepting new patients
J C Blair Memorial Hospital CurrentSince Sep 28, 2023 Accepting new patients
Tombigbee Healthcare Authority CurrentSince Jan 20, 2015 Accepting new patients
J C Blair Memorial Hospital CurrentSince Sep 28, 2023 Accepting new patients
State of Alabama Dept of Mental Health & Mental Retardation Current Accepting new patients
Mental Health BD of Bibb Pickens and Tuscaloosa Counties CurrentSince Feb 27, 2023 Accepting new patients
Medicine Beyond Walls, LLC Past Accepting new patients
J C Blair Memorial Hospital Past Accepting new patients
Cullman County Medical Clinic Inc Past Accepting new patients
Medicine Beyond Walls, LLC Past Accepting new patients

Locations

105 US Highway 80 E
Demopolis, AL 36732
Phone (334) 287-2669

1957 Hoover Ct
Ste 307C
Hoover, AL 35226
Phone (205) 644-1166

9064 Helena Rd
Pelham, AL 35124
Phone (205) 644-1166

115 Harper Ct
Tuscaloosa, AL 35401
Phone (205) 366-3010

1651 Ruby Tyler Pkwy
Tuscaloosa, AL 35404
Phone (205) 507-8000

200 University Blvd
Tuscaloosa, AL 35401
Phone (205) 759-0715

1225 Warm Springs Ave
Huntingdon, PA 16652
Phone (814) 643-8206

Interoperability endpoints

  • Direct secure messaging: antonowsky.coleman.1@12717.direct.athenahealth.com

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 12

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1063529485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21231",
            "address_2": "200 UNIVERSITY BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354021231",
            "telephone_number": "205-759-0904",
            "fax_number": "205-759-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WARM SPRINGS AVE",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166522350",
            "telephone_number": "814-643-8880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354021231",
            "country_code": "US",
            "telephone_number": "205-759-0904",
            "fax_number": "205-759-0931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "ANTONOWSKY",
        "middle_name": "D",
        "credential": "PSYCHIATRY MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "00024899",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD482601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1042228050001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "051529652",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051556361",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon, PA

Sources for this page

Verify at the official NPI Registry.