Active NPI
Macy Shea Coleman, PTA
- Physical Therapy Assistant
- Eastman, GA
National Provider Identifier
1528631256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA004649
- Practice address
- 815 Legion Dr
Eastman, GA 31023-6782 - Phone
- (478) 374-5571
- NPI assigned
- Jul 21, 2021
- Last updated
- Jul 21, 2021
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA004649 | GA | Primary |
Addresses
Primary practice location
815 Legion Dr
Eastman, GA 31023-6782
Mailing address
640 Pine Haven Dr
Eastman, GA 31023-7120
Phone (478) 231-2971
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA004649 | GA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626825600000",
"number": "1528631256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 PINE HAVEN DR",
"city": "EASTMAN",
"state": "GA",
"postal_code": "310237120",
"telephone_number": "478-231-2971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 LEGION DR",
"city": "EASTMAN",
"state": "GA",
"postal_code": "310236782",
"telephone_number": "478-374-5571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "MACY",
"middle_name": "SHEA",
"name_prefix": "Ms.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-21",
"last_updated": "2021-07-21",
"certification_date": "2021-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "PTA004649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastman, GA
- Chattahoochee Family Orthodontics
- Children and Teen Dental Group (American Dental of Eastman)
- Martha Paul Clelland, CSA
- Abby Lane Clements
- Crystal Stonecypher Coleman, COTA
- Community Service Board of Middle Ga
- Community Service Board of Middle Georgia (Eastman Day Services)
- Community Service Board of Middle Georgia (Eastman Clinic)
- Community Service Board of Middle Georgia (Building Hope)
- Comprehensive Family Medicine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.