Active NPI
Shautoria Coleman
- Physician Assistant
- Weaver, AL
National Provider Identifier
1619665734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1109 Alpine Dr
Weaver, AL 36277-3209 - Phone
- (256) 453-8537
- NPI assigned
- Apr 26, 2023
- Last updated
- Apr 26, 2023
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | Primary |
Addresses
Primary practice location
1109 Alpine Dr
Weaver, AL 36277-3209
Mailing address
1109 Alpine Dr
Weaver, AL 36277-3209
Phone (256) 453-8537
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Morehouse School of Medicine, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1810 Mulkey Rd
Suite 202
Austell, GA 30106-1150
Phone (770) 694-6349
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clearminds Behavioral Health LLC | Physician Assistant | 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.
-
- Psychiatry Physician
- Austell, GA
- NPI 1598250342
-
- Psychiatry Physician
- Palo Alto, CA
- NPI 1437833753
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682467200000",
"number": "1619665734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1109 ALPINE DR",
"city": "WEAVER",
"state": "AL",
"postal_code": "362773209",
"telephone_number": "256-453-8537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1109 ALPINE DR",
"city": "WEAVER",
"state": "AL",
"postal_code": "362773209",
"telephone_number": "256-453-8537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "SHAUTORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-26",
"last_updated": "2023-04-26",
"certification_date": "2023-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weaver, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.