Coleman Institute- Indiana Peter Richard Coleman Sole MBR

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02001067A Issued in IN

Legal business name

COLEMAN INSTITUTE- INDIANA PETER RICHARD COLEMAN SOLE MBR

Doing business as

Jeffersonville Family Practice

Practice address

1035 Wall St
Suite 204
Jeffersonville, IN 47130-3612

Phone

(812) 288-8410

Fax

(812) 288-8409

NPI assigned

Jun 17, 2010

Organization subpart

No

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

Authorized official

Name

Steven F Shields

Title

Billing Manager

Phone

(804) 282-9133

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jeffersonville Family Practice Doing business as

Locations

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1235450867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 WALL ST",
            "address_2": "SUITE 204",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303612",
            "telephone_number": "812-288-8410",
            "fax_number": "812-288-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 WALL ST",
            "address_2": "SUITE 204",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303612",
            "telephone_number": "812-288-8410",
            "fax_number": "812-288-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLEMAN INSTITUTE- INDIANA PETER RICHARD COLEMAN SOLE MBR",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "804-282-9133"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001067A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437214731",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffersonville Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth M Cochran
• Martinique Coffey
• Troy Dale Coker, O.D.
• Craig Cole, KCSA
• Monica Elaine Cole, RN
• Jenna N Collins, PA-C
• Susan Collins, LCSW
• Terri Diane Collins
• Kelly J. Colomb, M.D.
• Colondds P.C.

• Family Medicine Physician in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.