Individual provider Active NPI

Colleen Leigh Laurent, ATC, DO

  • Family Medicine Physician
  • Chillicothe, OH
National Provider Identifier
1154694438
Registry record updated May 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.015550 Issued in OH
Practice address
4461 State Route 159 Ste a
Chillicothe, OH 45601-6000
Phone
(740) 779-4900
NPI assigned
Feb 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096.002978 IL
Student in an Organized Health Care Education/Training Program 390200000X OH
Family Medicine Physician 207Q00000X 34.015550 OH Primary

Addresses

Primary practice location

4461 State Route 159 Ste a
Chillicothe, OH 45601-6000

Mailing address

4461 State Route 159 Ste a
Chillicothe, OH 45601-6000
Phone (740) 779-4900

Other practice location 1

205 W Wacker Dr
suite 1020
Chicago, IL 60606-1216
Phone (617) 750-5560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230817001507 OH Practitioner - Family Practice 8123353422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.015550OHMDFamily Medicine Physician
096.002978ILMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Jul 26, 2023 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

5195 Mayfield Rd
Lyndhurst, OH 44124
Phone (216) 559-5300

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685145600000",
    "number": "1154694438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4461 STATE ROUTE 159 STE A",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456016000",
            "telephone_number": "740-779-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4461 STATE ROUTE 159 STE A",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456016000",
            "telephone_number": "740-779-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 W Wacker Dr",
            "address_2": "suite 1020",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606061216",
            "country_code": "US",
            "telephone_number": "617-750-5560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAURENT",
        "first_name": "COLLEEN",
        "middle_name": "LEIGH",
        "credential": "ATC, DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-16",
        "last_updated": "2023-05-27",
        "certification_date": "2023-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.002978",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.015550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.