Active NPI
Loutrina Evon Coleman, CNA
- Home Health Aide
- Mount Vernon, GA
National Provider Identifier
1669063327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- CN0028892899
- Practice address
- 1139 Flora St
Mount Vernon, GA 30445-2756 - Phone
- (912) 246-0883
- NPI assigned
- Jan 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | CN0028892899 | GA | Primary |
Addresses
Primary practice location
1139 Flora St
Mount Vernon, GA 30445-2756
Mailing address
1139 Flora St
Mount Vernon, GA 30445-2756
Phone (912) 246-0883
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | graceofcare@yahoo.com |
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 |
|---|---|---|---|
| CN0028892899 | GA | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611619200000",
"number": "1669063327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1139 FLORA ST",
"city": "MOUNT VERNON",
"state": "GA",
"postal_code": "304452756",
"telephone_number": "912-246-0883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1139 FLORA ST",
"city": "MOUNT VERNON",
"state": "GA",
"postal_code": "304452756",
"telephone_number": "912-246-0883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "LOUTRINA",
"middle_name": "EVON",
"name_prefix": "Ms.",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-26",
"last_updated": "2021-01-26",
"certification_date": "2021-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "GA",
"license": "CN0028892899",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "graceofcare@yahoo.com",
"affiliation": "N",
"address_1": "1139 Flora St",
"city": "Mount Vernon",
"state": "GA",
"country_code": "US",
"postal_code": "304452756",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mount Vernon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.