Organization Active NPI

Coffman Family Care and Wellness PLLC

  • Clinic/Center
  • Beaver Dam, KY
National Provider Identifier
1649997669
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COFFMAN FAMILY CARE AND WELLNESS PLLC
Practice address
1101 Town Square Dr
Beaver Dam, KY 42320-9135
Phone
(270) 775-6060
Fax
(270) 775-6010
NPI assigned
Oct 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Authorized official

Name
Angela Coffman, APRN-FNP-C, PMHNPNPI 1811503410
Title
Lead Aprn
Phone
(270) 775-6060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1101 Town Square Dr
Beaver Dam, KY 42320-9135

Mailing address

1221 N Main St
Beaver Dam, KY 42320-8955
Phone (270) 775-6060

Other practice location 1

1102 Triplett St Ste 2200
Owensboro, KY 42303-3135
Phone (270) 775-6060

Other practice location 2

1221 N Main St
Beaver Dam, KY 42320-8955
Phone (270) 256-5911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221221000317 KY Part B Supplier - Clinic/Group Practice 1759751456 Receives reassigned benefits from 5 practitioners
Practice locations: Beaver Dam, KY; Owensboro, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2307432Coffman Family Care and Wellness1102 Triplett St, Owensboro, KY 42303Certificate of waiverJul 8, 2028

National Provider Directory

National Provider Directory

Locations

1221 N Main St
Beaver Dam, KY 42320
Phone (270) 256-5911

1101 Town Square Dr
Beaver Dam, KY 42320

1102 Triplett St
Owensboro, KY 42303
Phone (270) 274-9221

1102 Triplett St
Ste 2200
Owensboro, KY 42303
Phone (270) 685-2979

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1649997669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 N MAIN ST",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "423208955",
            "telephone_number": "270-775-6060",
            "fax_number": "270-775-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 TOWN SQUARE DR",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "423209135",
            "telephone_number": "270-775-6060",
            "fax_number": "270-775-6010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1102 Triplett St Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423033135",
            "country_code": "US",
            "telephone_number": "270-775-6060",
            "fax_number": "270-775-6010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 N Main St",
            "address_purpose": "LOCATION",
            "city": "Beaver Dam",
            "state": "KY",
            "postal_code": "423208955",
            "country_code": "US",
            "telephone_number": "270-256-5911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COFFMAN FAMILY CARE AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-20",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "COFFMAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "LEAD APRN",
        "authorized_official_telephone_number": "270-775-6060",
        "authorized_official_credential": "APRN-FNP-C, PMHNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.