Active NPI
Nathan Conrad Coffin, DC
- Chiropractor
- Redlands, CA
National Provider Identifier
1336307206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 19086
- Practice address
- 112 E Olive Ave
Suite B
Redlands, CA 92373-5281 - Phone
- (909) 793-9355
- Fax
- (909) 793-9350
- NPI assigned
- May 28, 2008
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 19086 | CA | Primary |
Addresses
Primary practice location
112 E Olive Ave
Suite B
Redlands, CA 92373-5281
Mailing address
112 E Olive Ave
Suite B
Redlands, CA 92373-5281
Phone (909) 793-9355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151214002477 | CA | Practitioner - Chiropractic | 3274834353 | Practice locations: Redlands, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
16 E Fern Ave
Redlands, CA 92373-4000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19086 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1336307206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 E OLIVE AVE",
"address_2": "SUITE B",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923735281",
"telephone_number": "909-793-9355",
"fax_number": "909-793-9350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 E OLIVE AVE",
"address_2": "SUITE B",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923735281",
"telephone_number": "909-793-9355",
"fax_number": "909-793-9350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFIN",
"first_name": "NATHAN",
"middle_name": "CONRAD",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-28",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "19086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.