Charmaine D Coffman-Williams

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2012033085 Issued in MO

Practice address

428 S 36TH St
Quincy, IL 62301-5924

Phone

(217) 224-6300

Fax

(217) 224-4329

NPI assigned

Mar 13, 2020

Last updated

Mar 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1083240741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N 2ND ST STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012894",
            "telephone_number": "636-224-1210",
            "fax_number": "636-946-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 S 36TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623015924",
            "telephone_number": "217-224-6300",
            "fax_number": "217-224-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN-WILLIAMS",
        "first_name": "CHARMAINE",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2012033085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip E Clark, DDS
• Sandra Clark, PHD
• Angela R Clevenger, CFNP
• Clinical Radiologists, S.C.
• Clinical Radiologists, S.C.
• Cogent Healthcare of Illinois, LLC
• Cole Vision Corporation (Sears Optical #C0101)
• Christopher James Coleman, AGACNP-BC
• Katherine Louise Collins, MD
• Jakin Kaohe Colvin, MSW

• Licensed Practical Nurse in Quincy, IL
• Providers in Quincy, IL by specialty
• Licensed Practical Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.