Individual provider Active NPI

Salema Coaxum, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1487021911
Registry record updated Jul 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
23829 Issued in SC
Practice address
2715 Colonial Dr
Columbia, SC 29203-6818
Phone
(803) 898-4802
NPI assigned
Sep 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 23829 SC Primary

Addresses

Primary practice location

2715 Colonial Dr
Columbia, SC 29203-6818

Mailing address

2715 Colonial Dr
Columbia, SC 29203-6818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NV, CO, CA, GA5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20190502000454 NC Practitioner - Nurse Practitioner 4082956537 Reassigns benefits to 2 organizations
I20210416001100 NV Practitioner - Nurse Practitioner 4082956537 Reassigns benefits to 2 organizations
I20220825002824 CO Practitioner - Nurse Practitioner 4082956537 Reassigns benefits to 1 organization
I20240705000485 CA Practitioner - Nurse Practitioner 4082956537 Reassigns benefits to 1 organization
I20260120003083 GA Practitioner - Nurse Practitioner 4082956537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

1202 Town Park LN
Suite 300
Evans, GA 30809-3477
Phone (770) 389-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP200458GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Mental Health Fund Inc CurrentSince Oct 2, 2019 Accepting new patients
Community Reach Center, Inc CurrentSince Aug 1, 2022 Accepting new patients
Diana Wright, Psy.D., LLC CurrentSince Apr 23, 2022 Accepting new patients
Behavioral Health Solutions LLC CurrentSince Mar 10, 2021 Accepting new patients
Lifesource of North Carolina CurrentSince Sep 1, 2020 Accepting new patients
The Mental Health Fund Inc Current Accepting new patients
Foothills Consulting Associates LLC CurrentSince Mar 30, 2019 Accepting new patients
Community Reach Center, Inc CurrentSince Aug 1, 2022 Accepting new patients
County of Butte Current Accepting new patients
Lifesource of North Carolina Psychiatric/Mental Health CurrentSince Sep 1, 2020 Accepting new patients
County of Butte CurrentSince Sep 1, 2024 Accepting new patients
Personal Recovery Network LLC CurrentSince Dec 10, 2025 Accepting new patients
Next Level Psychiatry Arizona PLLC CurrentSince Mar 10, 2021 Accepting new patients
County of Butte CurrentSince Sep 1, 2024 Accepting new patients

Locations

3217 Cohasset Rd
Cohasset, CA 95973
Phone (530) 552-4578

995 Spruce St
Gridley, CA 95948
Phone (530) 846-7305

100 Spader Way
Broomfield, CO 80020
Phone (720) 887-2220

100 Spader Way
Ste 267
Broomfield, CO 80020

8931 Huron St
Thornton, CO 80260
Phone (303) 853-3433

1870 W 122nd Ave
Ste 100
Westminster, CO 80234
Phone (303) 853-3800

1202 Town Park Ln
Ste 300
Evans, GA 30809
Phone (706) 210-8855

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

327 1st Ave NW
Hickory, NC 28601
Phone (828) 695-2125

615 S DeKalb St
Shelby, NC 28150
Phone (704) 473-4653

1610 E Marion St
Ste 250
Shelby, NC 28150
Phone (704) 480-1882

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

2200 Paseo Verde Pkwy
Ste 190
Henderson, NV 89052
Phone (702) 483-5061

4600 Kietzke Ln
Ste N250
Reno, NV 89502
Phone (775) 500-0396

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783123200000",
    "number": "1487021911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036818",
            "telephone_number": "803-898-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COAXUM",
        "first_name": "SALEMA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2026-07-04",
        "certification_date": "2026-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "23829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.