Mary Ann Coghlan, APRN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1127035 Issued in TX

Practice address

1526 Leander Rd
Georgetown, TX 78628-8801

Phone

(512) 863-7586

NPI assigned

Jul 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1750069258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 JOSEY WALES DR",
            "city": "JARRELL",
            "state": "TX",
            "postal_code": "765370730",
            "telephone_number": "469-531-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 LEANDER RD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786288801",
            "telephone_number": "512-863-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGHLAN",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1127035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rolphson Clervoix
• Clifton B. O'Meara, Mdpa
• Kayla Cloud, LPC
• Jenna Coe, OTR, MOT, C/NDT
• Melissa Coello
• Helena Aletta Cohen, MA, LMHC, LPC
• Kimberly Coker, M.S. CCC-SLP
• James M. Colbert, M. ED., LPC
• Cara Elizabeth Coligan
• Caitlyn Ashley Collins, LPC ASSOCIATE

• Pediatric Nurse Practitioner in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.