Individual provider Active NPI

Stanley Roger Coleman, MD

  • Child & Adolescent Psychiatry Physician
  • Charlotte, NC
National Provider Identifier
1760498802
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
9800818 Issued in NC
Practice address
501 Billingsley Rd
Ste B
Charlotte, NC 28211-1009
Phone
(704) 444-2400
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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 9800818 NC
Child & Adolescent Psychiatry Physician 2084P0804X 9800818 NC Primary

Addresses

Primary practice location

501 Billingsley Rd
Ste B
Charlotte, NC 28211-1009

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

16740 Davidson Concord Rd
Davidson, NC 28036-8746
Phone (704) 444-2400

Other practice location 2

706 W King St
Kings Mountain, NC 28086-2708
Phone (980) 487-5470

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address scoleman125058@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141104001574 SC Practitioner - Psychiatry 9335361591 Reassigns benefits to 1 organization
I20151228002386 NC Practitioner - Psychiatry 9335361591 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18315SCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Oct 29, 2015 Accepting new patients
Carolinas Medical Center Psychiatry CurrentSince Oct 29, 2015 Accepting new patients
Carolinas Medical Center Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Aug 12, 2014 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Aug 12, 2014 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

501 Billingsley Rd
Ste B
Charlotte, NC 28211
Phone (704) 444-2400

16740 Davidson Concord Rd
Davidson, NC 28036
Phone (704) 444-2400

706 W King St
Kings Mtn, NC 28086
Phone (704) 730-5108

524 Doctors Ct
Chester, SC 29706
Phone (803) 325-7744

448 Lakeshore Pkwy
Ste 205
Rock Hill, SC 29730
Phone (803) 323-0007

Interoperability endpoints

  • Direct secure messaging: scoleman125058@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1760498802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BILLINGSLEY RD",
            "address_2": "STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "704-444-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16740 Davidson Concord Rd",
            "address_purpose": "LOCATION",
            "city": "Davidson",
            "state": "NC",
            "postal_code": "280368746",
            "country_code": "US",
            "telephone_number": "704-444-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "706 W King St",
            "address_purpose": "LOCATION",
            "city": "Kings Mountain",
            "state": "NC",
            "postal_code": "280862708",
            "country_code": "US",
            "telephone_number": "980-487-5470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "STANLEY",
        "middle_name": "ROGER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9800818",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "9800818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scoleman125058@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "501 Billingsley Rd",
            "address_2": "Ste B",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282111009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.