Individual provider Active NPI

Barbara Coleman

  • Family Nurse Practitioner
  • Southaven, MS
National Provider Identifier
1174344295
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10240509 Issued in MS
Practice address
3828 Cobblewood Dr
Southaven, MS 38672-6556
Phone
(901) 289-5749
NPI assigned
Oct 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10240509 MS
Primary Care Nurse Practitioner 363LP2300X 10240509 MS
Family Nurse Practitioner 363LF0000X 10240509 MS Primary

Addresses

Primary practice location

3828 Cobblewood Dr
Southaven, MS 38672-6556

Mailing address

3828 Cobblewood Dr
Southaven, MS 38672-6556
Phone (901) 289-5749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251024004071 MS Practitioner - Nurse Practitioner 6002050077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7615 Clarington CV
Southaven, MS 38671-5647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10240509MSMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Landmark Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients

Locations

7615 Clarington Cv
Southaven, MS 38671
Phone (662) 536-2500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJIHAA

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.

NPI Registry JSON

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1174344295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3828 COBBLEWOOD DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386726556",
            "telephone_number": "901-289-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3828 COBBLEWOOD DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386726556",
            "telephone_number": "901-289-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "BARBARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "10240509",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "10240509",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "10240509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.