Individual provider Active NPI

Beverly R Williams Coleman, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1316274814
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3006248 Issued in KY
Practice address
2237 Hikes LN
Louisville, KY 40218-2203
Phone
(502) 479-8390
Fax
(502) 479-8934
NPI assigned
Nov 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3006248 KY Primary

Addresses

Primary practice location

2237 Hikes LN
Louisville, KY 40218-2203

Mailing address

555 S Floyd St Ofc 4050
Louisville, KY 40202-3822
Phone (502) 852-0830

Other identifiers 1

IdentifierTypeStateIssuer
7100201260MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100702000066 KY Practitioner - Nurse Practitioner 9638200801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Jul 24, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jul 24, 2019 Accepting new patients
Park Duvalle Community Health Center, Inc Past Accepting new patients
Park Duvalle Community Health Center, Inc Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

5601 S 3rd St
#100
Louisville, KY 40214
Phone (502) 361-8801

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

555 S Floyd St
Ofc 4050
Louisville, KY 40202

401 E Chestnut St
Unit 310
Louisville, KY 40202
Phone (502) 584-8563

501 S Preston St
Louisville, KY 40202
Phone (502) 852-5096

501 S Preston St
Ste 48
Louisville, KY 40202

Organizations & group practices 4

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": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1316274814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S FLOYD ST OFC 4050",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023822",
            "telephone_number": "502-852-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2237 HIKES LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402182203",
            "telephone_number": "502-479-8390",
            "fax_number": "502-479-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS COLEMAN",
        "first_name": "BEVERLY",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-04",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3006248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100201260",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.