Individual provider Active NPI

Gerard Coulon, MD

  • General Practice Physician
  • Topeka, KS
National Provider Identifier
1073597225
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
04-19528 Issued in KS
Practice address
6725 SW 29TH St
Topeka, KS 66614-5625
Phone
(785) 354-0517
Fax
(785) 478-1508
NPI assigned
Dec 1, 2005
Last updated
Jan 31, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 04-19528 KS Primary

Addresses

Primary practice location

6725 SW 29TH St
Topeka, KS 66614-5625

Mailing address

6725 SW 29TH St
Topeka, KS 66614-5625
Phone (785) 354-0517

Other identifiers 1

IdentifierTypeStateIssuer
100138780CMedicaidKS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15521LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1073597225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 SW 29TH ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666145625",
            "telephone_number": "785-354-0517",
            "fax_number": "785-478-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6725 SW 29TH ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666145625",
            "telephone_number": "785-354-0517",
            "fax_number": "785-478-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULON",
        "first_name": "GERARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KS",
            "license": "04-19528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100138780C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.