Individual provider Active NPI

Chanel Coleman

  • Physician Assistant
  • Clayton, NC
National Provider Identifier
1700420940
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2076 Veterans Pkwy Ste 220
Clayton, NC 27520-5303
Phone
(919) 214-2306
NPI assigned
Oct 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2076 Veterans Pkwy Ste 220
Clayton, NC 27520-5303

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954

Other practice location 1

1001 Stadium Dr Ste 108
Wake Forest, NC 27587-3308
Phone (984) 263-2761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211006000219 NC Practitioner - Physician Assistant 5193123115 Reassigns benefits to 5 organizations
I20240215004453 VA Practitioner - Physician Assistant 5193123115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avance Care PAGroup PAC ID 3577634476, 244 clinicians
Mindpath Care Centers North Carolina PLLCGroup PAC ID 4688655517, 115 clinicians

Practice addresses (Care Compare)

1001 Stadium Dr
Suite 108
Wake Forest, NC 27587-3308
Phone (984) 263-2761

2076 Veterans Pkwy
Suite 220
Clayton, NC 27520-5303
Phone (919) 550-3323

7510 Ramble Way
Suite 107
Raleigh, NC 27616-4305
Phone (919) 747-3033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Best Day Psychiatry and Counseling, PC Psychiatry CurrentSince Aug 3, 2021 Accepting new patients
Best Day Psychiatry and Counseling, PC Psychiatry CurrentSince Aug 3, 2021 Accepting new patients
Mindpath Care Centers, North Carolina, PLLC Psychiatry CurrentSince Nov 1, 2025 Accepting new patients

Locations

3835 N Freeway Blvd
Ste 100
Sacramento, CA 95834
Phone (916) 576-7898

4 Doctors Park
Ste H
Asheville, NC 28801
Phone (828) 633-6070

2076 Veterans Pkwy
Ste 220
Clayton, NC 27520
Phone (919) 214-2306

2587 Ravenhill Dr
Fayetteville, NC 28303
Phone (910) 323-1545

609 Attain St
Ste 101
Fuquay Varina, NC 27526
Phone (910) 725-1708

Interoperability endpoints

  • Direct secure messaging: thrivinglanellc.chanelcoleman@149897.advancedmd-direct.com
  • Direct secure messaging: mpsc.chanel.coleman@114018.advancedmd-direct.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1700420940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2076 VETERANS PKWY STE 220",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205303",
            "telephone_number": "919-214-2306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Stadium Dr Ste 108",
            "address_purpose": "LOCATION",
            "city": "Wake Forest",
            "state": "NC",
            "postal_code": "275873308",
            "country_code": "US",
            "telephone_number": "984-263-2761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "CHANEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-31",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.