Individual provider Active NPI

Jeffrey R Coleman, O.D.

  • Optometrist
  • Wilmington, NC
National Provider Identifier
1326047689
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1329 Issued in NC
Practice address
919 S 16TH St
Wilmington, NC 28401-8015
Phone
(910) 762-4004
Fax
(910) 762-1605
NPI assigned
Jul 19, 2005
Last updated
May 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1329 NC Primary

Addresses

Primary practice location

919 S 16TH St
Wilmington, NC 28401-8015

Mailing address

919 S 16TH St
Wilmington, NC 28401-8015
Phone (910) 762-4004

Other identifiers 1

IdentifierTypeStateIssuer
890910GMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120307000817 NC Practitioner - Optometry 1759495120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

919 S 16TH St
Wilmington, NC 28401-8015
Phone (910) 762-4004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1329NCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jeffrey R Coleman Optometrist PA Optometrist CurrentSince Nov 11, 1989 Accepting new patients

Locations

919 S 16th St
Wilmington, NC 28401
Phone (910) 392-1321

Interoperability endpoints

  • Direct secure messaging: mcoleman@drcoleman.eyefinitydirect.com

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1326047689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284018015",
            "telephone_number": "910-762-4004",
            "fax_number": "910-762-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284018015",
            "telephone_number": "910-762-4004",
            "fax_number": "910-762-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890910G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.