Grayson Elise Coulombe, DPM

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

41000490A Issued in IN

Practice address

10122 E 10TH St Ste 230
Indianapolis, IN 46229-2664

Phone

(317) 355-7356

NPI assigned

Apr 3, 2024

Last updated

Jun 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: gcoulombe570360@ecommunitydirect.com

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1639921612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10122 E 10TH ST STE 230",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292664",
            "telephone_number": "317-355-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10122 E 10TH ST STE 230",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292664",
            "telephone_number": "317-355-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULOMBE",
        "first_name": "GRAYSON",
        "middle_name": "ELISE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "41000490A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300091942",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew M Cougill, MD
• Jennifer Cerven Cougill, PHARMD
• Madelyn Jo Cougill, RBT
• Stephen Cookson Cougill, DDS
• Alimatou Coulibaly
• Elizabeth Coulson, NP
• Allison Marie Coulston
• Chloe Coulter, MD
• Joanne Coulter, NP
• Patrick Michael Coulter, DDS

• Student in an Organized Health Care Education/Training Program in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.