Individual provider Active NPI

Eileen Coleman, MPT

  • Pediatric Physical Therapist
  • Pfafftown, NC
National Provider Identifier
1609001544
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
7742 Issued in NC
Practice address
3504 Grandview Club Rd
Pfafftown, NC 27040-9704
Phone
(336) 407-9753
NPI assigned
May 21, 2009
Last updated
Oct 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 7742 NC Primary

Addresses

Primary practice location

3504 Grandview Club Rd
Pfafftown, NC 27040-9704

Mailing address

1915 W Park Dr
Ste 102
North Wilkesboro, NC 28659-3777
Phone (336) 903-9293

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

LicenseStateTypeSpecialty
7742NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapyworks, Inc Past Accepting new patients
Physical Therapy Associates of Wilkes LLC Pediatrics PastSince Jul 25, 2018 Accepting new patients

Organizations & group practices 2

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": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1609001544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 W PARK DR",
            "address_2": "STE 102",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593777",
            "telephone_number": "336-903-9293",
            "fax_number": "336-903-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 GRANDVIEW CLUB RD",
            "city": "PFAFFTOWN",
            "state": "NC",
            "postal_code": "270409704",
            "telephone_number": "336-407-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "EILEEN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "7742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pfafftown, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.