Active NPI
Cynthia M Coletti, MD
- Family Medicine Physician
- Johnson City, TN
National Provider Identifier
1851301303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD31852
- Practice address
- 1019 W Oakland Ave
Suite 1
Johnson City, TN 37604-2357 - Phone
- (423) 915-5000
- Fax
- (423) 915-5045
- NPI assigned
- Aug 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD31852 | TN | Primary |
Addresses
Primary practice location
1019 W Oakland Ave
Suite 1
Johnson City, TN 37604-2357
Mailing address
1019 W Oakland Ave
Suite 1
Johnson City, TN 37604-2357
Phone (423) 915-5000
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3846088 GRP 3706268 | Medicaid | TN | |
| TN01G5 | Other | TN | JOHN DEERE |
| TN01M5 | Other | TN | JOHN DEERE |
| 3130635 | Other | TN | BCBS |
| 3846085 GRP3706267 | Medicaid | TN | |
| 3846086 GRP 3709285 | Medicaid | TN | |
| TN0100 | Other | TN | JOHN DEERE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD31852 | TN | MD | Family Medicine Physician |
| 31852 | TN | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266451200000",
"number": "1851301303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1019 W OAKLAND AVE",
"address_2": "SUITE 1",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042357",
"telephone_number": "423-915-5000",
"fax_number": "423-915-5045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1019 W OAKLAND AVE",
"address_2": "SUITE 1",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042357",
"telephone_number": "423-915-5000",
"fax_number": "423-915-5045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLETTI",
"first_name": "CYNTHIA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2010-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "MD31852",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3846088 GRP 3706268",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "TN01G5",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "TN01M5",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "3130635",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3846085 GRP3706267",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3846086 GRP 3709285",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "TN0100",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.