Glendell B. Coleman, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Blakely, GA
NPI 1962755421 · NPPES record last updated Oct 11, 2024
Key facts
- NPI
- 1962755421
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN094148 (GA)
- Practice address
- 11740 Columbia St
Blakely, GA 39823-2574 - Phone
- (229) 724-4282
- Fax
- (229) 724-4283
- NPI assigned
- Oct 22, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lifebrite Hospital Group of Early LLC
Practice addresses (Care Compare)
11045 Columbia St
Blakely, GA 39823-3447
Phone (229) 723-4313
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121128000649 | GA | Practitioner - Nurse Practitioner | 4688826514 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifebrite Hospital Group of Early LLC | Current |
Accepting new patients | |
| Department of Behavioral Health & Developmental Disabilities, Ga | Current |
Accepting new patients | |
| Department of Behavioral Health & Developmental Disabilities | Current |
Accepting new patients | |
| Lifebrite Hospital Group of Early LLC | Current |
Accepting new patients | |
| Department of Behavioral Health and Developmental Disabilities | Current | Accepting new patients | |
| Lifebrite Hospital Group of Early LLC | Current | Accepting new patients | |
| Middle Flint Area Community Service Board | Current |
Accepting new patients | |
| Georgia Pines Community Service Board | Current |
Accepting new patients | |
| Middle Flint Area Community Service Board | Current | Accepting new patients |
Locations
415 N Jackson St
Americus, GA 31709
Phone (229) 815-5454
3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030
11045 Columbia St
Blakely, GA 39823
Phone (228) 723-4313
630 Columbia St
Blakely, GA 39823
Phone (229) 723-4241
1915 Eisenhower Dr
Savannah, GA 31406
Phone (912) 356-2011
1102 Smith Ave
Ste H
Thomasville, GA 31792
Phone (229) 225-5208
1102 Smith Ave
Ste K
Thomasville, GA 31792
Phone (912) 227-5468
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN094148 | GA | Yes |
Addresses
Primary practice location
11740 Columbia St
Blakely, GA 39823-2574
Mailing address
11740 Columbia St
Blakely, GA 39823-2574
Phone (229) 724-4282
Other providers in Blakely, GA
- Leigh Ford Bruner
- Calhoun County Dept of Family & Children Services
- Lakeisha Cannon-Scott
- Careplus Medical Services LLC
- Robert Allan Cibiras
- Melissa Bonner Conner
- Missy Maleigh Cox
- Whitney Alexander Crawford
- Department of Family and Children Services
- Department of Family and Children Services of Seminole County
All providers in Blakely, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.