Jessica Renee Coleman, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA9063 Issued in AL

Practice address

12110 County Line Rd Ste B
Madison, AL 35756-2009

Phone

(256) 232-9001

Fax

(256) 233-1001

NPI assigned

Aug 19, 2019

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

Other names 1

• Jessica Renee Canary Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Benchmark Physical Therapy of Alabama, LLC

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1659642916
  NPD
• Benchmark Physical Therapy of Alabama, LLC

  • Physical Therapist
  • Moody, AL
  • NPI 1417386434
  NPD (past)

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1770130486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 COUNTY LINE RD STE B",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357562009",
            "telephone_number": "256-232-9001",
            "fax_number": "256-233-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AL",
            "license": "PTA9063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "CANARY",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Clinic for Women, P.a.
• Charles D. Coffey, M.D.
• Amelia M Cohen, LPC
• Melanie Cole, LPC, NCC, ED D
• Christopher Coleman, RBT
• Ciara Collier Thomas, LICSW, LCSW
• Brittany Ann Collier, M.S., BCBA
• Alison Elaine Colvin, M.S., CCC-SLP
• Courtney Lynn Comans
• Community Urgent Care of Madison, Inc

• Physical Therapy Assistant in Madison, AL
• Providers in Madison, AL by specialty
• Physical Therapy Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.