Gary Michael Coleman

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35075 Issued in KY

Practice address

1350 Medical Park Dr
Maysville, KY 41056-9615

Phone

(606) 759-5437

Fax

(606) 759-9267

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gary.michael.coleman.1@13661.direct.athenahealth.com

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.

• Lewis County Primary Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Vanceburg, KY
  • NPI 1457303802

  KY

  Medicare reassignment NPD
• Lewis County Primary Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Morehead, KY
  • NPI 1215643440
  NPD
• Meadowview Regional Medical Center LLC

  • Rural Acute Care Hospital
  • Maysville, KY
  • NPI 1881785863
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1124125224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "411790550",
            "telephone_number": "606-956-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 MEDICAL PARK DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410569615",
            "telephone_number": "606-759-5437",
            "fax_number": "606-759-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "GARY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "35075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64357056",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Rogers Caudill, BS, TCADC
• Brandi Champion
• Charlotte J. Harris, MD, PSC
• Rebecca G. Church, LPCC
• Hayley Clark, APRN
• Abby Nicole Collins
• Leslie Perry Collins, PT
• Rae Ann Colvin
• Kyra C Combess
• Comprehend Inc Regional Mental Health- Mental Retardation Board Inc

• All providers in Maysville, KY
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.