Active NPI
Brian David Coon, PT
- Physical Therapist
- Erie, PA
National Provider Identifier
1619097722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT007026L
- Practice address
- 2101 Nagle Rd
Erie, PA 16510-2131 - Phone
- (814) 877-7078
- Fax
- (814) 899-5484
- NPI assigned
- Mar 30, 2007
- Last updated
- May 6, 2008
- Sex
- Male
- 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 Therapist | 225100000X | PT007026L | PA | Primary |
Addresses
Primary practice location
2101 Nagle Rd
Erie, PA 16510-2131
Mailing address
717 State St
Suite 16, LL
Erie, PA 16501-1341
Phone (814) 480-7100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1616794 | Other | PA | AETNA |
| 0015328390004 | Medicaid | PA | |
| 762502 | Other | PA | BLUE SHIELD |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional Health Services Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210032000000",
"number": "1619097722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 STATE ST",
"address_2": "SUITE 16, LL",
"city": "ERIE",
"state": "PA",
"postal_code": "165011341",
"telephone_number": "814-480-7100",
"fax_number": "814-480-7604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 NAGLE RD",
"city": "ERIE",
"state": "PA",
"postal_code": "165102131",
"telephone_number": "814-877-7078",
"fax_number": "814-899-5484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COON",
"first_name": "BRIAN",
"middle_name": "DAVID",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-30",
"last_updated": "2008-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT007026L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1616794",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0015328390004",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "762502",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.