Individual provider Active NPI

Kimberly Coles

  • Case Manager/Care Coordinator
  • Williamsburg, VA
National Provider Identifier
1346711801
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1451 Manor Blvd
Williamsburg, VA 23185-2843
Phone
(757) 707-3374
Fax
(757) 707-3374
NPI assigned
Dec 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X VA Primary

Addresses

Primary practice location

1451 Manor Blvd
Williamsburg, VA 23185-2843

Mailing address

PO Box 6364
Williamsburg, VA 23188-5222
Phone (757) 707-3374

Other identifiers 1

IdentifierTypeStateIssuer
0592812595MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1346711801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6364",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885222",
            "telephone_number": "757-707-3374",
            "fax_number": "757-707-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 MANOR BLVD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852843",
            "telephone_number": "757-707-3374",
            "fax_number": "757-707-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLES",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0592812595",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.