Organization Active NPI

Jamie M Coleman MD

  • Eyewear Supplier
  • Walla Walla, WA
National Provider Identifier
1437364163
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
JAMIE M COLEMAN MD
Practice address
1610 Penny LN
Walla Walla, WA 99362-4477
Phone
(509) 529-3160
Fax
(509) 529-3241
NPI assigned
May 14, 2007
Last updated
Aug 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Authorized official

Name
Kathie L Mason
Title
Office Manager
Phone
(509) 529-1284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1610 Penny LN
Walla Walla, WA 99362-4477

Mailing address

PO Box 1663
Walla Walla, WA 99362-0031
Phone (509) 529-1284

Other identifiers 2

IdentifierTypeStateIssuer
056874MedicaidOR
1077544MedicaidWA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1437364163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1663",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620031",
            "telephone_number": "509-529-1284",
            "fax_number": "509-522-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 PENNY LN",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624477",
            "telephone_number": "509-529-3160",
            "fax_number": "509-529-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMIE M COLEMAN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "KATHIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "509-529-1284"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056874",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1077544",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.