Individual provider Active NPI

Kathryn Coffman, M.D.

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1093722506
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
14553 Issued in AZ
Practice address
2346 N Central Ave
Phoenix, AZ 85004-1329
Phone
(602) 282-0078
Fax
(602) 282-0102
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 14553 AZ Primary

Addresses

Primary practice location

2346 N Central Ave
Phoenix, AZ 85004-1329

Mailing address

1919 E Thomas Rd
BLDG 2108, Suite 101
Phoenix, AZ 85016-7710
Phone (602) 512-8029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120321000229 AZ Practitioner - Pediatric Medicine 9638339179 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14553AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Jan 26, 2012 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jan 26, 2012 Accepting new patients
Phoenix Children'S Hospital Hope Past Accepting new patients

Locations

2120 N Central Ave
Phoenix, AZ 85004
Phone (602) 271-4500

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

2346 N Central Ave
Phoenix, AZ 85004
Phone (602) 234-1935

1919 E Thomas Rd
Bldg 2108
Phoenix, AZ 85016
Phone (602) 512-8030

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1093722506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "address_2": "BLDG 2108, SUITE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-512-8029",
            "fax_number": "602-512-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2346 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041329",
            "telephone_number": "602-282-0078",
            "fax_number": "602-282-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "KATHRYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "14553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.