Coggin Avenue Medical Park PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

COGGIN AVENUE MEDICAL PARK PLLC

Practice address

2201 Coggin Ave
Brownwood, TX 76801-4734

Phone

(325) 646-7828

Fax

(325) 646-7888

NPI assigned

May 27, 2009

Last updated

Mar 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Katy M Lord

Title

Facility Manager

Phone

(325) 646-7828

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexis Stephens, FNP-BC

  • Family Nurse Practitioner
  • Columbus, OH
  • NPI 1235416470
  NPD (past)

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1609001239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 COGGIN AVE",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768014734",
            "telephone_number": "325-646-7828",
            "fax_number": "325-646-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 COGGIN AVE",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768014734",
            "telephone_number": "325-646-7828",
            "fax_number": "325-646-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGGIN AVENUE MEDICAL PARK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "LORD",
        "authorized_official_first_name": "KATY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FACILITY MANAGER",
        "authorized_official_telephone_number": "325-646-7828",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205587301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Dwayne Clardy, D.D.S.
• Clayton Cleveland, PHARMD
• Terrell Morelock Cleveland, PHARMD
• Clinical Partners PA - Brownwood
• Michael J Cloy, PA
• Adam Michael Coley, DDS
• Elizabeth King Colglazier, CRNA
• Leigh Ann Collins, D.O.
• Comolli & Ethridge
• Kent Collier Comolli, OD

• Family Nurse Practitioner in Brownwood, TX
• Providers in Brownwood, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.