Individual provider Active NPI

Czarmi Ann Coffman, PT

  • Physical Therapist
  • Beaver Dam, KY
National Provider Identifier
1366034837
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
005866 Issued in KY
Practice address
227 S Main St
Beaver Dam, KY 42320-2131
Phone
(270) 274-9221
Fax
(270) 955-2003
NPI assigned
Feb 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 005866 KY Primary

Addresses

Primary practice location

227 S Main St
Beaver Dam, KY 42320-2131

Mailing address

1088 Hidden Valley Dr
Morgantown, KY 42261-8550
Phone (270) 526-1111

Other practice location 1

1300 Campbell Ln
Bowling Green, KY 42104-4162
Phone (270) 782-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628003450 KY Practitioner - Physical Therapist in Private Practice 8426417130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fuller Physical TherapyGroup PAC ID 6507054889, 7 clinicians

Practice addresses (Care Compare)

227 S Main St
Beaver Dam, KY 42320-2131
Phone (270) 274-9221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005866KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fuller Physical Therapy Single Specialty CurrentSince May 15, 2023 Accepting new patients
The P.T. Place, Inc Single Specialty Past Accepting new patients

Locations

227 S Main St
Beaver Dam, KY 42320
Phone (270) 274-9221

358 S Main St
Leitchfield, KY 42754
Phone (270) 256-2932

113 Ashley Plaza Cir
Morgantown, KY 42261
Phone (270) 288-5105

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1366034837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 HIDDEN VALLEY DR",
            "city": "MORGANTOWN",
            "state": "KY",
            "postal_code": "422618550",
            "telephone_number": "270-526-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 S MAIN ST",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "423202131",
            "telephone_number": "270-274-9221",
            "fax_number": "270-955-2003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Campbell Ln",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421044162",
            "country_code": "US",
            "telephone_number": "270-782-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "CZARMI",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-06",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "005866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.

Verify at the official NPI Registry.