Individual provider Active NPI

Sydney Anne Coldren, PA-C

  • Physician Assistant
  • Lansing, MI
National Provider Identifier
1093264152
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008322 Issued in MI
Practice address
3520 Forest Rd
Lansing, MI 48910-3720
Phone
(517) 975-7800
Fax
(517) 975-7810
NPI assigned
Sep 29, 2016
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008322 MI Primary
Physician Assistant 363A00000X 020189 NY
Physician Assistant 363A00000X 0010-09483 NC

Addresses

Primary practice location

3520 Forest Rd
Lansing, MI 48910-3720

Mailing address

4100 Beecher Rd Ste a
Flint, MI 48532-3661
Phone (810) 342-3813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171106000968 MI Practitioner - Physician Assistant 7214293380 Reassigns benefits to 1 organization
I20191115002663 NC Practitioner - Physician Assistant 7214293380 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Oct 14, 2019 Accepting new patients
First Choice Medical PLLC PastSince Jan 24, 2002 Accepting new patients
R&T Medical PC PastSince Sep 1, 2017 Accepting new patients

Locations

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8524/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1093264152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 BEECHER RD STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323661",
            "telephone_number": "810-342-3813",
            "fax_number": "810-342-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 FOREST RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489103720",
            "telephone_number": "517-975-7800",
            "fax_number": "517-975-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLDREN",
        "first_name": "SYDNEY",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008322",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020189",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.