Individual provider Active NPI

Zachary Joseph Coffman, M.D.

  • Pediatric Critical Care Medicine Physician
  • Charlotte, NC
National Provider Identifier
1508109364
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME145837 Issued in FL
Practice address
1000 Blythe Blvd Ste 500
Charlotte, NC 28203-5812
Phone
(704) 373-1813
NPI assigned
Mar 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME145837 FL
Pediatrics Physician 208000000X 321914 NC
Pediatric Critical Care Medicine Physician 2080P0203X ME145837 FL Primary
Pediatric Cardiology Physician 2080P0202X ME145837 FL
Pediatric Cardiology Physician 2080P0202X 321914 NC
Pediatric Critical Care Medicine Physician 2080P0203X 321914 NC
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1000 Blythe Blvd Ste 500
Charlotte, NC 28203-5812

Mailing address

1001 Blythe Blvd Ste 500
Charlotte, NC 28203-5863
Phone (704) 373-1813

Other practice location 1

501 6th Ave S
St Petersburg, FL 33701-4634
Phone (864) 884-5910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211228002032 FL Practitioner - Critical Care (Intensivists)Practitioner - Cardiovascular Disease (Cardiology) 2860621596 Reassigns benefits to 1 organization
I20241108002929 NC Practitioner - Pediatric Medicine 2860621596 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME145837FLMDPediatric Critical Care Medicine Physician
321914NCMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Physician Services, Inc. Pediatrics CurrentSince Oct 20, 2021 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc. Pediatric Cardiology CurrentSince Jul 1, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

1000 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 373-1813

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: zcoffman742218@direct.hopkinsmedicine.org
  • Direct secure messaging: zcoffman2889103@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1508109364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035863",
            "telephone_number": "704-373-1813",
            "fax_number": "704-342-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-373-1813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 6th Ave S",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337014634",
            "country_code": "US",
            "telephone_number": "864-884-5910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "ZACHARY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-30",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME145837",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "321914",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME145837",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME145837",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NC",
            "license": "321914",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NC",
            "license": "321914",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.