Individual provider Active NPI

Nicole Coleman, DPT

  • Physical Therapist
  • Chesapeake, VA
National Provider Identifier
1447773718
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305208658 Issued in VA
Practice address
680B Kingsborough SQ Ste B
Chesapeake, VA 23320-4986
Phone
(757) 547-0264
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT012160 GA
Physical Therapist 225100000X 2305208658 VA Primary

Addresses

Primary practice location

680B Kingsborough SQ Ste B
Chesapeake, VA 23320-4986

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224

Other practice location 1

1301 Cedar Rd
Chesapeake, VA 23322-7105
Phone (757) 512-7626

Other practice location 2

1035 Southcrest Dr
Stockbridge, GA 30281-6118
Phone (770) 389-9052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CA, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190628000193 GA Practitioner - Physical Therapist in Private Practice 5890029607 Reassigns benefits to 3 organizations
I20220321000706 CA Practitioner - Physical Therapist in Private Practice 5890029607 Reassigns benefits to 1 organization
I20240723003237 VA Practitioner - Physical Therapist in Private Practice 5890029607 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT012160GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Sport & Spine Therapy of Marin Inc Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Jun 13, 2024 Accepting new patients
The Weston Group Inc. Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Jun 13, 2024 Accepting new patients
The Weston Group Inc. Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Oct 16, 2019 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Oct 16, 2019 Accepting new patients
Sport & Spine Therapy of Marin Inc Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients

Locations

88 Rowland Way
Ste 250
Novato, CA 94945
Phone (415) 484-1163

2725 Holcomb Bridge Rd
Alpharetta, GA 30022
Phone (770) 649-0808

1100 Reinhardt College Pkwy
Canton, GA 30114
Phone (770) 721-2812

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

2275 Beech Ave
Buena Vista, VA 24416
Phone (540) 466-1000

680 Kingsborough Sq
Ste B
Chesapeake, VA 23320
Phone (757) 547-0434

1301 Cedar Rd
Chesapeake, VA 23322
Phone (757) 512-7626

Organizations & group practices 11

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": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1447773718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680B KINGSBOROUGH SQ STE B",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204986",
            "telephone_number": "757-547-0264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Cedar Rd",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233227105",
            "country_code": "US",
            "telephone_number": "757-512-7626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1035 Southcrest Dr",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302816118",
            "country_code": "US",
            "telephone_number": "770-389-9052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012160",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.