Individual provider Active NPI

Elizabeth V Coffman, LISW

  • Clinical Social Worker
  • Springfield, OH
National Provider Identifier
1962599878
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0000724 Issued in OH
Practice address
1130 Vester Ave
Suite C
Springfield, OH 45503-7302
Phone
(937) 390-3800
Fax
(937) 390-3804
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Clinical Social Worker 1041C0700X I0000724 OH Primary

Addresses

Primary practice location

1130 Vester Ave
Suite C
Springfield, OH 45503-7302

Mailing address

1130 Vester Ave
Suite C
Springfield, OH 45503-7302
Phone (937) 390-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120127000655 OH Practitioner - Clinical Social Worker 9830083906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Positive Perspectives IncGroup PAC ID 8527952696, 7 clinicians

Practice addresses (Care Compare)

4949 Urbana Rd
Springfield, OH 45502-8387
Phone (937) 390-3800

566 E Dayton Yellow Springs Rd
Fairborn, OH 45324-6433
Phone (937) 390-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0000724OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Perspectives, Inc. Clinical CurrentSince Jan 16, 1996 Accepting new patients

Locations

566 E Dayton Yellow Springs Rd
Fairborn, OH 45324
Phone (937) 390-3800

1130 Vester Ave
Ste C
Springfield, OH 45503
Phone (937) 390-3800

4949 Urbana Rd
Springfield, OH 45502
Phone (937) 390-3800

4949 Urbana Rd
Ste 201
Springfield, OH 45502
Phone (937) 390-3800

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962599878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 VESTER AVE",
            "address_2": "SUITE C",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455037302",
            "telephone_number": "937-390-3800",
            "fax_number": "937-390-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 VESTER AVE",
            "address_2": "SUITE C",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455037302",
            "telephone_number": "937-390-3800",
            "fax_number": "937-390-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "ELIZABETH",
        "middle_name": "V",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0000724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.