Active NPI
Barry John Coughlin, MD FACC
- Cardiovascular Disease Physician
- Lompoc, CA
National Provider Identifier
1205812468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- C31374
- Practice address
- 136 North Third St Ste 1
Lompoc, CA 93436 - Phone
- (805) 735-7771
- Fax
- (805) 735-9911
- NPI assigned
- Dec 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | C31374 | CA | Primary |
Addresses
Primary practice location
136 North Third St Ste 1
Lompoc, CA 93436
Mailing address
PO Box 567
Lompoc, CA 93438
Phone (805) 736-1875
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ38994Z | Other | CA | BLUE SHIELD OF CALIFORNIA |
| 00C313740 | Medicaid | CA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C31374 | CA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiovascular Center of Lompoc a Medical Corporation | Cardiovascular Disease | 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 and National Provider Directory roles.
-
- Clinical Medical Laboratory
- Lompoc, CA
- NPI 1124045059
Cardiovascular Disease
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1205812468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 567",
"city": "LOMPOC",
"state": "CA",
"postal_code": "93438",
"telephone_number": "805-736-1875",
"fax_number": "805-735-9911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 NORTH THIRD ST STE 1",
"city": "LOMPOC",
"state": "CA",
"postal_code": "93436",
"telephone_number": "805-735-7771",
"fax_number": "805-735-9911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUGHLIN",
"first_name": "BARRY",
"middle_name": "JOHN",
"credential": "MD FACC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-20",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "C31374",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CALIFORNIA",
"identifier": "ZZZ38994Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C313740",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lompoc, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.