Individual provider Active NPI

Tara Ranita Edwards-Coleman, RN

  • Registered Nurse
  • Cleveland, OH
National Provider Identifier
1063644086
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
445261 Issued in OH
Practice address
17325 Euclid Ave Ste 3022
Cleveland, OH 44112-1255
Phone
(216) 260-3444
NPI assigned
Aug 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN-133601 OH
Registered Nurse 163W00000X 445261 OH Primary

Addresses

Primary practice location

17325 Euclid Ave Ste 3022
Cleveland, OH 44112-1255

Mailing address

732 Quilliams Rd
Cleveland Heights, OH 44121-1956
Phone (216) 785-4486

Other practice location 1

732 Quilliams Rd
Cleveland Hts, OH 44121-1956
Phone (216) 785-4486

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
445261OHMDRegistered Nurse
PN-133601OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gifted Hands Healthcare Academy LLC CurrentSince Aug 1, 2020 Accepting new patients

Locations

17325 Euclid Ave
Ste 3022
Cleveland, OH 44112
Phone (216) 260-3444

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1063644086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 QUILLIAMS RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441211956",
            "telephone_number": "216-785-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17325 EUCLID AVE STE 3022",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441121255",
            "telephone_number": "216-260-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "732 Quilliams Rd",
            "address_purpose": "LOCATION",
            "city": "Cleveland Hts",
            "state": "OH",
            "postal_code": "441211956",
            "country_code": "US",
            "telephone_number": "216-785-4486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS-COLEMAN",
        "first_name": "TARA",
        "middle_name": "RANITA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN-133601",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "445261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.