NPIMap

Individual provider Active NPI

William C Coulter, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1376591065
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA436 Issued in KY
Practice address
12600 Creekside LN Ste 6
Fort Myers, FL 33919
Phone
(239) 343-9219
Fax
(239) 343-9221
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA436 KY
Surgical Physician Assistant 363AS0400X PA436 KY
Physician Assistant 363A00000X PA436 KY Primary

Addresses

Primary practice location

12600 Creekside LN Ste 6
Fort Myers, FL 33919

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9219

Other practice location 1

160 N Eagle Creek Dr
Ste 307
Lexington, KY 40509-2124
Phone (859) 226-0031

Other identifiers 3

IdentifierTypeStateIssuer
000000655589OtherKYANTHEM BCBS
000000667983OtherKYCOOP HEALTH ANTHEM #
95001442MedicaidKY

Other names 1

  • Chuck Coulter Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070515000352 KY Practitioner - Physician Assistant 0143327809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone (502) 636-7225

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 893-1270

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1270

4960 Norton Healthcare Blvd
Louisville, KY 40241-2831
Phone (502) 446-8125

6420 Dutchmans Pkwy
Suite 200
Louisville, KY 40205-3373
Phone (502) 891-8300

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • Norton-King'S Daughters' Health Hospital, Madison, IN, CCN 150069
  • Norton Clark Hospital Hospital, Jeffersonville, IN, CCN 150009

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA436KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Community Medical Associates, Inc. CurrentSince Jan 1, 2023 Accepting new patients
University of Kentucky CurrentSince Feb 8, 2019 Accepting new patients
Lee Health System Inc Past Accepting new patients
Community Medical Associates, Inc. Physician Assistant Past Accepting new patients
Gastroenterology Associates of Central Ky PSC Past Accepting new patients
Danville Cardiovascular Consultants, PSC Past Accepting new patients
Marshall Emergency Services Associates, PLLC Physician Assistant Past Accepting new patients
Owensboro Health Medical Group Inc Past Accepting new patients

Locations

309 11th St
Carrollton, KY 41008
Phone (502) 732-3241

1250 Ben Ali Dr
Danville, KY 40422
Phone (859) 236-0903

279 Kings Daughters Dr
Ste 204
Frankfort, KY 40601
Phone (502) 875-9885

207 Fairgrounds Rd
Hardinsburg, KY 40143
Phone (270) 580-2256

325 W Walnut St
Lebanon, KY 40033
Phone (270) 699-9500

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

210 E Gray St
Ste 1002
Louisville, KY 40202
Phone (502) 584-2027

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

6420 Dutchmans Pkwy
Ste 200
Louisville, KY 40205
Phone (502) 891-8333

4420 Dixie Hwy
Ste 118
Louisville, KY 40216
Phone (502) 447-3448

815 E Parrish Ave
Ste 150
Owensboro, KY 42303
Phone (270) 688-0808

815 E Parrish Ave
#240
Owensboro, KY 42303
Phone (270) 688-0808

815 E Parrish Ave
Ste 240
Owensboro, KY 42303
Phone (270) 688-0808

150 Frankfort Rd
Ste 102C
Shelbyville, KY 40065
Phone (502) 882-8414

Interoperability endpoints

  • Direct secure messaging: wcoulter19907@ukhcdirect.org
  • Direct secure messaging: wcoulter247695@direct.nortonhealthcare.org

Organizations & group practices 10

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1376591065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9219",
            "fax_number": "239-343-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 CREEKSIDE LN STE 6",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33919",
            "telephone_number": "239-343-9219",
            "fax_number": "239-343-9221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 N Eagle Creek Dr",
            "address_2": "Ste 307",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092124",
            "country_code": "US",
            "telephone_number": "859-226-0031",
            "fax_number": "859-514-0220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COULTER",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA436",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA436",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000655589",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COOP HEALTH ANTHEM #",
            "identifier": "000000667983",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95001442",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHUCK",
            "last_name": "COULTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.