Active NPI
Eileen Coleman, MPT
- Pediatric Physical Therapist
- Pfafftown, NC
National Provider Identifier
1609001544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 7742
- Practice address
- 3504 Grandview Club Rd
Pfafftown, NC 27040-9704 - Phone
- (336) 407-9753
- NPI assigned
- May 21, 2009
- Last updated
- Oct 18, 2016
- 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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 7742 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapyworks, Inc | Past | Accepting new patients | |
| Physical Therapy Associates of Wilkes LLC | Pediatrics | Past | 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.
-
- Physical Therapy Clinic/Center
- Pfafftown, NC
- NPI 1467743005
-
- Physical Therapist
- North Wilkesboro, NC
- NPI 1922183920
Pediatrics
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.