Active NPI
Tabatha Irene Coghlan, S.T.N.A
- Nurse's Aide
- Elyria, OH
National Provider Identifier
1386885689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 400263440703
- Practice address
- 2119 Middle Ave
Elyria, OH 44035-7878 - Phone
- (440) 310-1352
- NPI assigned
- Mar 16, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 400263440703 | OH | Primary |
Addresses
Primary practice location
2119 Middle Ave
Elyria, OH 44035-7878
Mailing address
2119 Middle Ave
Elyria, OH 44035-7878
Phone (440) 310-1352
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2862540 | Medicaid | OH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 400263440703 | OH | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237161600000",
"number": "1386885689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2119 MIDDLE AVE",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440357878",
"telephone_number": "440-310-1352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2119 MIDDLE AVE",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440357878",
"telephone_number": "440-310-1352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COGHLAN",
"first_name": "TABATHA",
"middle_name": "IRENE",
"name_prefix": "Mrs.",
"credential": "S.T.N.A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-16",
"last_updated": "2009-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": "400263440703",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2862540",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elyria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.