Mark Christopher Coles, N.P.
Individual provider Active NPI Nurse Practitioner · Luray, VA
NPI 1457397168 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457397168
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 0017137066 (VA)
- Practice address
- 200 Memorial Dr
Luray, VA 22835-1000 - Phone
- (540) 743-4561
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0017137066 | VA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sentara Medical Group | Current |
Accepting new patients |
Locations
4000 Coliseum Dr
Ste 445
Hampton, VA 23666
Phone (757) 827-2127
850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162
1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323
2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0017137066 | VA | Yes |
Addresses
Primary practice location
200 Memorial Dr
Luray, VA 22835-1000
Mailing address
2365 Kerr Dr
Virginia Beach, VA 23454-6564
Phone (757) 426-5439
Other providers in Luray, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.