Active NPI
Daniel Ray Coleman, P.T.
- Physical Therapist
- Tenino, WA
National Provider Identifier
1275570574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00002127
- Practice address
- 397 Sussex Ave E
Ste a
Tenino, WA 98589-9272 - Phone
- (360) 264-6622
- Fax
- (360) 264-6624
- NPI assigned
- Jun 2, 2006
- Last updated
- Oct 9, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00002127 | WA | Primary |
Addresses
Primary practice location
397 Sussex Ave E
Ste a
Tenino, WA 98589-9272
Mailing address
9929 Johnson Point Rd NE
Olympia, WA 98516-9339
Phone (360) 438-8042
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121283 | Other | WA | LABOR & INDUSTRIES |
| 7091473 | Medicaid | WA | |
| TE5934 | Other | WA | REGENCE |
| CO5972 | Other | WA | PREMERA BLUE CROSS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00002127 | WA | MD | Physical Therapist |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1275570574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9929 JOHNSON POINT RD NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985169339",
"telephone_number": "360-438-8042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "397 SUSSEX AVE E",
"address_2": "STE A",
"city": "TENINO",
"state": "WA",
"postal_code": "985899272",
"telephone_number": "360-264-6622",
"fax_number": "360-264-6624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "DANIEL",
"middle_name": "RAY",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00002127",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "121283",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7091473",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "TE5934",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMERA BLUE CROSS",
"identifier": "CO5972",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tenino, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.