Active NPI
Abbey Coburn, PA-C
- Physician Assistant
- Ogden, UT
National Provider Identifier
1164020830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11819270-1206
- Practice address
- 6028 S Ridgeline Dr Ste 200
Ogden, UT 84405-6906 - Phone
- (801) 917-8500
- NPI assigned
- Oct 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11819270-1206 | UT | Primary |
Addresses
Primary practice location
6028 S Ridgeline Dr Ste 200
Ogden, UT 84405-6906
Mailing address
6028 S Ridgeline Dr Ste 200
Ogden, UT 84405-6906
Phone (801) 917-8500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11819270-1206 | UT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1164020830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6028 S RIDGELINE DR STE 200",
"city": "OGDEN",
"state": "UT",
"postal_code": "844056906",
"telephone_number": "801-917-8500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6028 S RIDGELINE DR STE 200",
"city": "OGDEN",
"state": "UT",
"postal_code": "844056906",
"telephone_number": "801-917-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBURN",
"first_name": "ABBEY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-14",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "11819270-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.