Individual provider Active NPI

Cathy Lynn Coffee, LPN

  • Licensed Practical Nurse
  • Willoughby, OH
National Provider Identifier
1205218401
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.129391-M-IV Issued in OH
Practice address
37312 Harlow Dr
Willoughby, OH 44094-5758
Phone
(440) 478-9228
NPI assigned
Jun 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.129391-M-IV OH Primary

Addresses

Primary practice location

37312 Harlow Dr
Willoughby, OH 44094-5758

Mailing address

37312 Harlow Dr
Willoughby, OH 44094-5758
Phone (440) 478-9228

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

LicenseStateTypeSpecialty
PN.129391-M-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1205218401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37312 HARLOW DR",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440945758",
            "telephone_number": "440-478-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37312 HARLOW DR",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440945758",
            "telephone_number": "440-478-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEE",
        "first_name": "CATHY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.129391-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.