Individual provider Active NPI

Charles Calvin Coleman, MD

  • Psychiatry Physician
  • New Orleans, LA
National Provider Identifier
1750429502
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
201352 Issued in LA
Practice address
1542 Tulane Ave Dept of
New Orleans, LA 70112-2865
Phone
(504) 896-7790
Fax
(504) 896-7273
NPI assigned
Feb 2, 2007
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 12767 GA
Psychiatry Physician 2084P0800X 201352 LA Primary

Addresses

Primary practice location

1542 Tulane Ave Dept of
New Orleans, LA 70112-2865

Mailing address

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 896-7790

Other identifiers 1

IdentifierTypeStateIssuer
1013471MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070605000307 LA Practitioner - Psychiatry 5092813667 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
201352LAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jul 1, 2018 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jul 1, 2018 Accepting new patients
Louisiana State University School of Med in New Orleans Faculty Grou CurrentSince Jul 1, 2015 Accepting new patients
Fawaz Abdrabbo MD Psychiatry Past Accepting new patients
Children's Hospital Past Accepting new patients
Mississippi Neuropsychiatric Clinic, PLLC Psychiatry Past Accepting new patients

Locations

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1750429502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-896-7790",
            "fax_number": "504-896-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 TULANE AVE DEPT OF",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122865",
            "telephone_number": "504-896-7790",
            "fax_number": "504-896-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "CHARLES",
        "middle_name": "CALVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "12767",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "201352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013471",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.