Andre A Coleman, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056009596 Issued in IL

Practice address

4110 S Water Tower Place
Mount Vernon, IL 62864-6567

Phone

(618) 242-1100

Fax

(618) 244-5148

NPI assigned

Dec 27, 2011

Last updated

Feb 2, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Select Physical Therapy Holdings, Inc.

  dba NovaCare Rehabilitation

  • Rehabilitation Clinic/Center
  • Benton, IL
  • NPI 1992352215
  Medicare reassignment NPD
• Select Physical Therapy Holdings Inc

  • Physical Therapy Clinic/Center
  • Chicago, IL
  • NPI 1942475488
  NPD
• Select Physical Therapy Holdings Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Ashland, VA
  • NPI 1174591218
  NPD

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1174892731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 S WATER TOWER PLACE",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646567",
            "telephone_number": "618-242-1100",
            "fax_number": "618-244-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 S WATER TOWER PLACE",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646567",
            "telephone_number": "618-242-1100",
            "fax_number": "618-244-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "ANDRE",
        "middle_name": "A",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-27",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056009596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarkson Optometry Illinois PC (Clarkson Eye Care)
• Keith Alan Cloe, D.C.
• Paula Clouse, LCPC, LPC
• Ashlie Cole, RD, LDN
• Jamie Renee Cole, M.S., SLP-CCC
• Michelle Collier
• Kim Ann Collins, MHP
• Jamie Josephine Compton, CRNA
• Vincent Coty Compton, CRNA
• Kelsey Conley, LPN

• Occupational Therapist in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.