Individual provider Active NPI

Charlene Coleman, L.P.N.

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1083873202
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
282243-1 Issued in NY
Practice address
267 Hazelwood Ter
Rochester, NY 14609-5220
Phone
(585) 360-4636
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 282243-1 NY Primary

Addresses

Primary practice location

267 Hazelwood Ter
Rochester, NY 14609-5220

Mailing address

267 Hazelwood Ter
P.O. Box 90553
Rochester, NY 14609-5220
Phone (585) 360-4636

Other identifiers 1

IdentifierTypeStateIssuer
02748974MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
282243-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1083873202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 HAZELWOOD TER",
            "address_2": "P.O. BOX 90553",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146095220",
            "telephone_number": "585-360-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 HAZELWOOD TER",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146095220",
            "telephone_number": "585-360-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "CHARLENE",
        "name_prefix": "Ms.",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "282243-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02748974",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.