Individual provider Active NPI

Phillip Norman Coleman, D.C.

  • Chiropractor
  • Morristown, TN
National Provider Identifier
1932283371
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000002015 Issued in TN
Practice address
1775 W Morris Blvd
Morristown, TN 37813-2835
Phone
(423) 587-5805
Fax
(423) 587-3311
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0000002015 TN Primary

Addresses

Primary practice location

1775 W Morris Blvd
Morristown, TN 37813-2835

Mailing address

1775 W Morris Blvd
Morristown, TN 37813-2835
Phone (423) 587-5805

Other identifiers 1

IdentifierTypeStateIssuer
4098747OtherTNBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170221000557 FL Practitioner - Chiropractic 8426094798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Wellness and Healthcare, IncGroup PAC ID 3678968070, 2 clinicians

Practice addresses (Care Compare)

3600 1St Ave N
St Petersburg, FL 33713-8407
Phone (727) 327-4522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC0000002015TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Wellness and Rehab LLC Chiropractor CurrentSince Feb 1, 2017 Accepting new patients
Bay Area Wellness & Healthcare, Inc Chiropractor CurrentSince Jan 2, 2022 Accepting new patients
Coleman Chiropractic, PLLC Chiropractor Past Accepting new patients
May Family Chiropractic PastSince Mar 10, 2015 Accepting new patients

Locations

6761 Land O Lakes Blvd
Land O Lakes, FL 34638
Phone (813) 929-8555

3600 1st Ave N
St Petersburg, FL 33713
Phone (727) 327-4522

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932283371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 W MORRIS BLVD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132835",
            "telephone_number": "423-587-5805",
            "fax_number": "423-587-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 W MORRIS BLVD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132835",
            "telephone_number": "423-587-5805",
            "fax_number": "423-587-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "PHILLIP",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000002015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "4098747",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.