Individual provider Active NPI

Irene L. Coronado, R.N., F.N.P, MSN

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1477622900
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP114989 Issued in TX
Practice address
4680 Lockhill Selma Rd Ste 200
San Antonio, TX 78249-2094
Phone
(210) 805-9800
NPI assigned
Nov 7, 2006
Last updated
Jun 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 567495 TX
Family Nurse Practitioner 363LF0000X AP114989 TX Primary

Addresses

Primary practice location

4680 Lockhill Selma Rd Ste 200
San Antonio, TX 78249-2094

Mailing address

45 NE Loop 410
Ste 850
San Antonio, TX 78216-5824
Phone (210) 805-9800

Other practice location 1

10423 State Highway 151 Ste 103
San Antonio, TX 78251-4768
Phone (210) 546-1400

Other identifiers 1

IdentifierTypeStateIssuer
2830549-02MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070402000599 TX Practitioner - Nurse Practitioner 7113021064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Texas Medical School at San Antonio, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Pain Partners PLLCGroup PAC ID 3274061783, 23 clinicians

Practice addresses (Care Compare)

4680 Lockhill Selma Rd
Suite 200
San Antonio, TX 78249-2094
Phone (210) 546-1480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
567495TXMDFamily Nurse Practitioner
AP114989TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Pain Partners PLLC CurrentSince Nov 1, 2024 Accepting new patients
Texas Pain Partners PLLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

10423 State Highway 151
Ste 103
San Antonio, TX 78251
Phone (210) 546-1470

3202 Cherry Ridge Dr
Ste 103
San Antonio, TX 78230
Phone (210) 441-4333

423 Treeline Park
Ste 325
San Antonio, TX 78209
Phone (210) 546-1460

45 NE Loop 410
Ste 850
San Antonio, TX 78216

4680 Lockhill Selma Rd
Ste 200
Shavano Park, TX 78249
Phone (210) 546-1470

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1477622900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 NE LOOP 410",
            "address_2": "STE 850",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165824",
            "telephone_number": "210-805-9800",
            "fax_number": "210-805-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 LOCKHILL SELMA RD STE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492094",
            "telephone_number": "210-805-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10423 State Highway 151 Ste 103",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782514768",
            "country_code": "US",
            "telephone_number": "210-546-1400",
            "fax_number": "210-546-1439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "IRENE",
        "middle_name": "L.",
        "credential": "R.N., F.N.P, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "567495",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP114989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2830549-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.