Individual provider Active NPI

Jeffrey David Coleman, O.D.

  • Optometrist
  • Joplin, MO
National Provider Identifier
1750512463
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2009009189 Issued in MO
Practice address
1030 SE Murphy Blvd
Joplin, MO 64801
Phone
(417) 782-3488
Fax
(417) 782-3488
NPI assigned
Jul 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2009009189 MO Primary

Addresses

Primary practice location

1030 SE Murphy Blvd
Joplin, MO 64801

Mailing address

1030 SE Murphy Blvd
Joplin, MO 64801-5043
Phone (417) 782-3488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091216000321 MO Practitioner - Optometry 3173663507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1030 SE Murphy Blvd
Joplin, MO 64801-5043

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2009009189MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Coleman Optometry PC Optometrist CurrentSince May 5, 2014 Accepting new patients

Locations

1030 SE Murphy Blvd
Joplin, MO 64801
Phone (417) 623-2828

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1750512463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 SE MURPHY BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648015043",
            "telephone_number": "417-782-3488",
            "fax_number": "417-782-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 SE MURPHY BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64801",
            "telephone_number": "417-782-3488",
            "fax_number": "417-782-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-29",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2009009189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.