Audrey Becker Coleman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2100 A1A S
St Augustine, FL 32080-6615

Phone

(904) 605-3553

NPI assigned

Sep 7, 2016

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Advanced Diagnostic Imaging, PC

  dba AdvancedHealth

  • Internal Medicine Physician
  • Goodlettsville, TN
  • NPI 1093741464

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732406400000",
    "number": "1285181289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 11TH ST N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503693",
            "telephone_number": "629-221-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 A1A S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806615",
            "telephone_number": "904-605-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "AUDREY",
        "middle_name": "BECKER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2024-11-24",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q025828",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "6089376",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cogent Healthcare of Jacksonville, LLC
• Maureen Elizabeth Cohen, LMHC
• Stanley A Cohen, D.O.P.A.
• Mathew Joseph Colaluca, DC
• Brittany Cole, OT
• Erin Coletti, DO
• Casey R Colin, DCN, RDN, LN, CNSC
• Isabela Collins, LAT, ATC
• Kayla Collins, OT
• Lacandace Collins, LMHC

• Physician Assistant in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2024; 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.