Active NPI
Candace Elizabeth Coffman, PT, DPT
- Physical Therapist
- Mansfield, OH
National Provider Identifier
1376789347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 012173
- Practice address
- 536 S Trimble Rd
Mansfield, OH 44906-3418 - Phone
- (419) 528-3150
- Fax
- (419) 528-3152
- NPI assigned
- Dec 23, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 012173 | OH | Primary |
Addresses
Primary practice location
536 S Trimble Rd
Mansfield, OH 44906-3418
Mailing address
7013 Bayton PL
New Albany, OH 43054-8117
Phone (440) 669-9395
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 012173 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SMR Banyan Tree, Inc. | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Dublin, OH
- NPI 1164458329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622678400000",
"number": "1376789347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7013 BAYTON PL",
"city": "NEW ALBANY",
"state": "OH",
"postal_code": "430548117",
"telephone_number": "440-669-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "536 S TRIMBLE RD",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449063418",
"telephone_number": "419-528-3150",
"fax_number": "419-528-3152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFMAN",
"first_name": "CANDACE",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-23",
"last_updated": "2021-06-03",
"certification_date": "2021-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT 012173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.