Individual provider Active NPI

Mary Thoesen Coleman, MD

  • Family Medicine Physician
  • Wesley Chapel, FL
National Provider Identifier
1275531352
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33350 Issued in KY
Practice address
30314 Fairway Dr
Wesley Chapel, FL 33543-4436
Phone
(305) 781-8198
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33350 KY Primary
Family Medicine Physician 207Q00000X ME107532 FL

Addresses

Primary practice location

30314 Fairway Dr
Wesley Chapel, FL 33543-4436

Mailing address

30314 Fairway Dr
Wesley Chapel, FL 33543-4436
Phone (305) 781-8198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111101000559 LA Practitioner - Family Practice 0446163562 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME107532FLMDFamily Medicine Physician
33350KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Oct 1, 2011 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Current Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Oct 1, 2011 Accepting new patients
University Physicians Group - Radiology Past Accepting new patients
University Family Practice Assoc. PSC Family Medicine Past Accepting new patients

Locations

433 Plaza St
Bogalusa, LA 70427
Phone (985) 730-6700

1542 Tulane Ave
Ste 659
New Orleans, LA 70112
Phone (504) 568-2314

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1275531352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30314 FAIRWAY DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335434436",
            "telephone_number": "305-781-8198",
            "fax_number": "504-290-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30314 FAIRWAY DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335434436",
            "telephone_number": "305-781-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "MARY",
        "middle_name": "THOESEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "33350",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME107532",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

Verify at the official NPI Registry.