NPIMap

Individual provider Active NPI

Collin Coffield, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • La Crosse, WI
National Provider Identifier
1881367399
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12289 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Jul 29, 2021
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 12289 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8352 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12289 WI Primary

Addresses

Primary practice location

1836 South Ave
La Crosse, WI 54601-5429

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other practice location 1

855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-2606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230913001559 WI Practitioner - Nurse Practitioner 5294132817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8352WIMDClinical Social Worker
8352MNMDGeneral Practice Dentistry
12289WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center, Inc. CurrentSince Sep 18, 2023 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Sep 18, 2023 Accepting new patients

Locations

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

Interoperability endpoints

  • Direct secure messaging: ccoffield219975@direct.emplifyhealth.org

Organizations & group practices 3

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1881367399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 Mankato Ave",
            "address_purpose": "LOCATION",
            "city": "Winona",
            "state": "MN",
            "postal_code": "559874868",
            "country_code": "US",
            "telephone_number": "507-454-2606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFIELD",
        "first_name": "COLLIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-29",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "12289",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8352",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "12289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.