NPIMap

Organization Active NPI

Darryl M Coleman MD PA

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1720475726
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DARRYL M COLEMAN MD PA
Practice address
2125 Maryland Ave
Suites 109 & 110
Baltimore, MD 21218-5634
Phone
(410) 244-8002
Fax
(410) 244-8810
NPI assigned
Apr 17, 2015
Last updated
Apr 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Authorized official

Name
Darryl M Coleman, M.D.NPI 1164565834
Title
Owner/Psychiatrist
Phone
(410) 744-7076

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

2125 Maryland Ave
Suites 109 & 110
Baltimore, MD 21218-5634

Mailing address

6630 Baltimore National Pike Ste 205B
Catonsville, MD 21228-3943
Phone (410) 744-7076

Other identifiers 1

IdentifierTypeStateIssuer
319202400MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Darryl M Coleman MD PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2125 Maryland Ave
Ste 109
Baltimore, MD 21218
Phone (410) 244-8002

6630 Baltimore National Pike
Ste 205B
Catonsville, MD 21228
Phone (410) 744-7076

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429228800000",
    "number": "1720475726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 BALTIMORE NATIONAL PIKE STE 205B",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212283943",
            "telephone_number": "410-744-7076",
            "fax_number": "410-744-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 MARYLAND AVE",
            "address_2": "SUITES 109 & 110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185634",
            "telephone_number": "410-244-8002",
            "fax_number": "410-244-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARRYL M COLEMAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-17",
        "last_updated": "2015-04-17",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PSYCHIATRIST",
        "authorized_official_telephone_number": "410-744-7076",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319202400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.