Laura Coffman
Individual provider Active NPI Community Health Worker · Eccles, WV
NPI 1679159404 · NPPES record last updated Mar 22, 2021
Key facts
- NPI
- 1679159404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 149 Eccles School Rd
Eccles, WV 25836 - Phone
- (304) 673-4125
- NPI assigned
- Mar 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
149 Eccles School Rd
Eccles, WV 25836
Mailing address
149 Eccles School Rd
Eccles, WV 25836
NPI Registry JSON
{
"created_epoch": "1616371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616371200000",
"number": "1679159404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 ECCLES SCHOOL RD",
"city": "ECCLES",
"state": "WV",
"postal_code": "25836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 ECCLES SCHOOL RD",
"city": "ECCLES",
"state": "WV",
"postal_code": "25836",
"telephone_number": "304-673-4125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFMAN",
"first_name": "LAURA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-22",
"last_updated": "2021-03-22",
"certification_date": "2021-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eccles, WV
All providers in Eccles, WV · Community Health Worker in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.