Ellen Rose Coffin

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1897 Tundra Way
Noorvik, AK 99763-0189

Phone

(907) 636-2103

NPI assigned

Jun 29, 2018

Sex

Female

Sole proprietor

No

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.

• Maniilaq Association

  • Federal Public Health Clinic/Center
  • Noorvik, AK
  • NPI 1720355456
  NPD (past)
• Maniilaq Association

  • Clinic/Center
  • Noorvik, AK
  • NPI 1902552573
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 23, 2020.

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1124513320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1897 TUNDRA WAY",
            "city": "NOORVIK",
            "state": "AK",
            "postal_code": "99763",
            "telephone_number": "907-636-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1897 TUNDRA WAY",
            "city": "NOORVIK",
            "state": "AK",
            "postal_code": "997630189",
            "telephone_number": "907-636-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFIN",
        "first_name": "ELLEN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Louise Beasley
• Dorothy Lydia Brown, CHP
• Cynthia Ann Coffin, CHP
• Carol Sophia Field
• Stanley Harvey, CHA I
• Maniilaq Association
• Maniilaq Association
• Flora M Newlin

• All providers in Noorvik, AK
• Community Health Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.