Jeremy Paul Coleman, LCDCII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCDCII.161841 Issued in OH

Practice address

4977 Northcutt PL
Dayton, OH 45414-3839

Phone

(937) 387-6395

NPI assigned

Jun 3, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Nova Behavioral Health, Inc

  • Substance Abuse Rehabilitation Facility
  • Dayton, OH
  • NPI 1548217748
  NPD (past)
• Nova Behavioral Health, Inc.

  • Substance Abuse Rehabilitation Facility
  • Dayton, OH
  • NPI 1164782017
  NPD (past)

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

{
    "created_epoch": "1527984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1245722511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4977 NORTHCUTT PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143839",
            "telephone_number": "937-387-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4977 NORTHCUTT PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143839",
            "telephone_number": "937-387-6395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1830 W High St",
            "address_purpose": "LOCATION",
            "city": "Piqua",
            "state": "OH",
            "postal_code": "453569399",
            "country_code": "US",
            "telephone_number": "513-834-7063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3095 Kettering Blvd",
            "address_purpose": "LOCATION",
            "city": "Moraine",
            "state": "OH",
            "postal_code": "454391983",
            "country_code": "US",
            "telephone_number": "937-293-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JEREMY",
        "middle_name": "PAUL",
        "credential": "LCDCII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-03",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCII.161841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0291711",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chaquela Coleman
• Florence Squire Coleman, M.D.
• Gabrielle Coleman
• Gary L Coleman Jr.
• Jacob Coleman, PHARMD
• Jhordyn Kasmere Coleman
• Johntay Coleman
• Joseph Samuel Coleman Jr.
• Karniesa Coleman, LPN
• Krystal R Coleman

• Addiction (Substance Use Disorder) Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.