Individual provider Active NPI

Amy Christine Coleman, LISW

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1164706487
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0018535-SUPV Issued in OH
Practice address
1800 Zollinger Rd FL 5
Columbus, OH 43221-2800
Phone
(614) 293-9600
Fax
(614) 293-1456
NPI assigned
Oct 5, 2011
Reactivated
Jul 25, 2023
Last updated
Sep 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I8535 OH
Clinical Social Worker 1041C0700X I.0018535-SUPV OH Primary

Addresses

Primary practice location

1800 Zollinger Rd FL 5
Columbus, OH 43221-2800

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559

Other practice location 1

921 Chatham Ln Ste 112
Columbus, OH 43221-2418
Phone (614) 754-7648

Other identifiers 2

IdentifierTypeStateIssuer
0210216MedicaidOH
2846675MedicaidOH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I8535OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Susan Weltner-Brunton, PH.D., Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1164706487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ZOLLINGER RD FL 5",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432212800",
            "telephone_number": "614-293-9600",
            "fax_number": "614-293-1456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 Chatham Ln Ste 112",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432212418",
            "country_code": "US",
            "telephone_number": "614-754-7648",
            "fax_number": "614-754-7965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "AMY",
        "middle_name": "CHRISTINE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "deactivation_date": "2019-08-18",
        "reactivation_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I8535",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0018535-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0210216",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.