Cynthia Coleman

Key facts

NPI

1124456074

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

APRN59912-FNP-BC (WV)

Practice address

4607 Maccorkle Ave SW
South Charleston, WV 25309-1364

Phone

(304) 414-2800

NPI assigned

Oct 30, 2013

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 10, 2019.

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1124456074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BRICK CIR",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253133407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091364",
            "telephone_number": "304-414-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "97 Great Teays Blvd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Scott Depot",
            "state": "WV",
            "postal_code": "255609816",
            "country_code": "US",
            "telephone_number": "304-757-6999",
            "fax_number": "304-201-5019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "116 Hills Plz",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253872438",
            "country_code": "US",
            "telephone_number": "304-720-4466",
            "fax_number": "304-720-4821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "CYNTHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN59912-FNP-BC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

• Cynthia Cochran
• Jazmine Skylar Raine Cochran
• Tomi Linnea Cochran
• Debra A Cogar
• Samantha Cole
• Jason Coleman
• Jessica Ann Coleman
• Lillian Coleman
• Patricia Coleman
• Selena Coleman

All providers in South Charleston, WV · Family Nurse Practitioner in West Virginia