Individual provider Active NPI

Elizabeth Therese Coffman, PA-C

  • Medical Physician Assistant
  • Henderson, NV
National Provider Identifier
1083125017
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2844 Issued in NV
Practice address
1701 N Green Valley Pkwy Ste 7B
Henderson, NV 89074-5889
Phone
(702) 508-9119
NPI assigned
Oct 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA2844 NV Primary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 5601010553 MI
Clinical Social Worker 1041C0700X 6802089761 MI

Addresses

Primary practice location

1701 N Green Valley Pkwy Ste 7B
Henderson, NV 89074-5889

Mailing address

1701 N Green Valley Pkwy Ste 7B
Henderson, NV 89074-5889
Phone (702) 508-9119

Other identifiers 2

IdentifierTypeStateIssuer
PA2844MedicaidNV
PA2844OtherNVPHYSICIAN ASSISTANT LICENSE

Other names 1

  • Elizabeth Therese Kreager Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20230908002757 NV Practitioner - Physician Assistant 2860898384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Apeksha Desai MD PLLCGroup PAC ID 8022486125, 7 clinicians

Practice addresses (Care Compare)

1701 N Green Valley Pkwy
Suite 7B
Henderson, NV 89074-5889
Phone (702) 508-9119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6802089761MIMDClinical Social Worker
5601010553MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Debra a. Glitz, M.D., P.L.L.C. Single Specialty CurrentSince Oct 1, 2022 Accepting new patients
Paton & Associates PLLC PastSince Oct 15, 2023 Accepting new patients
Gilbert R Ladd IV MD PC Single Specialty PastSince Oct 1, 2022 Accepting new patients
Comprehensive Urgent Care Past Accepting new patients

Locations

3290 W Big Beaver Rd
Ste 509
Troy, MI 48084
Phone (248) 290-2220

Interoperability endpoints

  • Direct secure messaging: ecoffman680890@direct.hfhs.org

Organizations & group practices 5

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": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1083125017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N GREEN VALLEY PKWY STE 7B",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745889",
            "telephone_number": "702-508-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N GREEN VALLEY PKWY STE 7B",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745889",
            "telephone_number": "702-508-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "ELIZABETH",
        "middle_name": "THERESE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA2844",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010553",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6802089761",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA2844",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "PA2844",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "KREAGER",
            "middle_name": "THERESE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.