Ted Coleman, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD60597143 Issued in WA

Practice address

11102 Sunrise Blvd E
Suite 103
Puyallup, WA 98374

Phone

(253) 848-8797

Fax

(253) 845-0100

NPI assigned

Jan 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1285612879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11102 SUNRISE BLVD E,",
            "address_2": "SUITE 103",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98374",
            "telephone_number": "253-848-8797",
            "fax_number": "253-845-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11102 SUNRISE BLVD E",
            "address_2": "SUITE 103",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98374",
            "telephone_number": "253-848-8797",
            "fax_number": "253-845-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "TED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301046463",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60597143",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60597143",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11273896",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285612879",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew William Cole
• Laura Ann Cole, COTA/L
• Christine Coleman
• Nikki L Coleman
• Ralph Coleman, MA
• Susan M Colkitt
• Collaborative Behavioral Approach
• Collaborative Care &Wellness
• Nicole D Collett, MD
• Fern S Collins, RPH

• Emergency Medicine Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.