Active NPI
Krystal M Coleman, NP
- Nurse Practitioner
- Stony Point, NC
National Provider Identifier
1477053718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 243787
- Practice address
- 35 Ruritan Park Rd
Stony Point, NC 28678-8928 - Phone
- (704) 585-9373
- Fax
- (704) 585-9397
- NPI assigned
- Feb 13, 2018
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 243787 | NC | Primary |
Addresses
Primary practice location
35 Ruritan Park Rd
Stony Point, NC 28678-8928
Mailing address
35 Ruritan Park Rd
Stony Point, NC 28678-8928
Phone (704) 585-9373
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | krystal.coleman.1@4693.direct.athenahealth.com |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 243787 | NC | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1477053718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 RURITAN PARK RD",
"city": "STONY POINT",
"state": "NC",
"postal_code": "286788928",
"telephone_number": "704-585-9373",
"fax_number": "704-585-9397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 RURITAN PARK RD",
"city": "STONY POINT",
"state": "NC",
"postal_code": "286788928",
"telephone_number": "704-585-9373",
"fax_number": "704-585-9397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "KRYSTAL",
"middle_name": "M",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-13",
"last_updated": "2020-09-10",
"certification_date": "2020-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "243787",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "krystal.coleman.1@4693.direct.athenahealth.com",
"affiliation": "N",
"endpointDescription": "AMR direct access",
"address_1": "35 Ruritan Park Rd",
"city": "Stony Point",
"state": "NC",
"country_code": "US",
"postal_code": "286788928",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Stony Point, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.