Individual provider Active NPI

Kathleen Coulter, CRNP

  • Adult Health Nurse Practitioner
  • Media, PA
National Provider Identifier
1487629663
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP006850C Issued in PA
Practice address
340 N Middletown Rd
Media, PA 19063-5597
Phone
(610) 891-5600
NPI assigned
Feb 21, 2006
Last updated
May 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X SP025692 PA
Adult Health Nurse Practitioner 363LA2200X SP006850C PA Primary
Gerontology Nurse Practitioner 363LG0600X SP006851H PA

Addresses

Primary practice location

340 N Middletown Rd
Media, PA 19063-5597

Mailing address

248 Springhouse LN
Media, PA 19063-5347
Phone (610) 721-0277

Other practice location 1

1 E Beacon Light Ln
Chester, PA 19013-4433
Phone (610) 490-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100707000055 PA Practitioner - Nurse Practitioner 6305977489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Health and Psychiatry PLLCGroup PAC ID 0547643876, 3 clinicians

Practice addresses (Care Compare)

340 N Middletown Rd
Fair Acres Nursing Home
Glen Riddle Lima, PA 19037-3977
Phone (610) 891-5840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP006850CPAMDAdult Health Nurse Practitioner
SP006851HPAMDGerontology Nurse Practitioner
SP025692PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Gerontology Associates LLP Multi-Specialty CurrentSince Jul 1, 2022 Accepting new patients
Bonner Physiatry Associates Multi-Specialty CurrentSince Feb 5, 2018 Accepting new patients
Advanced Health & Psychiatry, PLLC Multi-Specialty CurrentSince May 1, 2022 Accepting new patients
Carriage House Medical Group, LLC Multi-Specialty Past Accepting new patients
Physical Therapy Physicians PC Multi-Specialty Past Accepting new patients
Hearsay ENT Docs LLC Multi-Specialty Past Accepting new patients

Locations

1 E Beacon Light Ln
Chester, PA 19013
Phone (610) 490-3900

340 N Middletown Rd
Media, PA 19063
Phone (610) 565-7810

340 N Middletown Rd
#H
Media, PA 19063
Phone (610) 891-5715

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1487629663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 SPRINGHOUSE LN",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635347",
            "telephone_number": "610-721-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N MIDDLETOWN RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635597",
            "telephone_number": "610-891-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 E Beacon Light Ln",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "PA",
            "postal_code": "190134433",
            "country_code": "US",
            "telephone_number": "610-490-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COULTER",
        "first_name": "KATHLEEN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP025692",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP006850C",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP006851H",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.