Individual provider Active NPI

Jason D Coleman, DC

  • Chiropractor
  • Cordova, TN
National Provider Identifier
1871663773
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000000175 Issued in TN
Practice address
8132 Cordova Rd
Suite 102
Cordova, TN 38016-6005
Phone
(901) 751-0939
Fax
(901) 751-0332
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0000000175 TN Primary

Addresses

Primary practice location

8132 Cordova Rd
Suite 102
Cordova, TN 38016-6005

Mailing address

8132 Cordova Rd
Suite 102
Cordova, TN 38016-6005
Phone (901) 751-0939

Other identifiers 1

IdentifierTypeStateIssuer
4066937OtherTNBCBS

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

State licenses

LicenseStateTypeSpecialty
DC0000000175TNMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1871663773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8132 CORDOVA RD",
            "address_2": "SUITE 102",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380166005",
            "telephone_number": "901-751-0939",
            "fax_number": "901-751-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8132 CORDOVA RD",
            "address_2": "SUITE 102",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380166005",
            "telephone_number": "901-751-0939",
            "fax_number": "901-751-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JASON",
        "middle_name": "D",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000000175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4066937",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.