Individual provider Active NPI

Brittany Coleman

  • Nursing Home Administrator
  • Surprise, AZ
National Provider Identifier
1730820630
Registry record updated May 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Home AdministratorTaxonomy code 376G00000X
Practice address
15111 N 172ND Dr
Surprise, AZ 85388-7820
Phone
(480) 236-8393
NPI assigned
Apr 5, 2022
Last updated
May 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Home Administrator 376G00000X NU Primary

Addresses

Primary practice location

15111 N 172ND Dr
Surprise, AZ 85388-7820

Mailing address

2055 E Broadway Rd Apt 240
Mesa, AZ 85204-1484
Phone (480) 236-8393

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

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653177600000",
    "number": "1730820630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E BROADWAY RD APT 240",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852041484",
            "telephone_number": "480-236-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15111 N 172ND DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853887820",
            "telephone_number": "480-236-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-05-22",
        "certification_date": "2022-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2022; 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.