Active NPI
Peter Wadkin Coleman, MS, LMFT
- Marriage & Family Therapist
- Chattanooga, TN
National Provider Identifier
1215292461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 982
- Practice address
- 951 Eastgate Loop Ste 100
Chattanooga, TN 37411-5604 - Phone
- (423) 631-5923
- Fax
- (423) 296-6515
- NPI assigned
- Jul 12, 2012
- Last updated
- Apr 26, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Psychoanalyst | 102L00000X | |||
| Marriage & Family Therapist | 106H00000X | 982 | TN | Primary |
Addresses
Primary practice location
951 Eastgate Loop Ste 100
Chattanooga, TN 37411-5604
Mailing address
509 Oliver St
Chattanooga, TN 37405-4021
Phone (423) 631-5923
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3920247 | Medicaid | TN |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 982 | TN | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-State Psychiatry and Addiction Medicine, PLLC | Multi-Specialty | 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.
-
- Adult Mental Health Clinic/Center
- Chattanooga, TN
- NPI 1568852754
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524700800000",
"number": "1215292461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 OLIVER ST",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374054021",
"telephone_number": "423-631-5923",
"fax_number": "423-296-6515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "951 EASTGATE LOOP STE 100",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374115604",
"telephone_number": "423-631-5923",
"fax_number": "423-296-6515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "PETER",
"middle_name": "WADKIN",
"name_prefix": "Mr.",
"credential": "MS, LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-12",
"last_updated": "2018-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "TN",
"license": "982",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3920247",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.