Active NPI
Taekwonda Coleman
- Nurse's Aide
- Euclid, OH
National Provider Identifier
1730665746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 401332151211
- Practice address
- 24411 Mavec Ave
Euclid, OH 44123-2415 - Phone
- (216) 358-5074
- NPI assigned
- Jul 12, 2018
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 401332151211 | OH | Primary |
Addresses
Primary practice location
24411 Mavec Ave
Euclid, OH 44123-2415
Mailing address
24411 Mavec Ave
Euclid, OH 44123-2415
Phone (216) 358-5074
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 401332151211 | Other | OH | OHIO STATE TESTED NURSE AIDE |
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 |
|---|---|---|---|
| 401332151211 | OH | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1730665746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24411 MAVEC AVE",
"city": "EUCLID",
"state": "OH",
"postal_code": "441232415",
"telephone_number": "216-358-5074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24411 MAVEC AVE",
"city": "EUCLID",
"state": "OH",
"postal_code": "441232415",
"telephone_number": "216-358-5074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "TAEKWONDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-12",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": "401332151211",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO STATE TESTED NURSE AIDE",
"identifier": "401332151211",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Euclid, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.