Active NPI
Kelly Alan Coleman, PT
- Orthopedic Physical Therapist
- Springfield, MO
National Provider Identifier
1982863353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 2004036179
- Practice address
- 1342 E Primrose Street
Suite a
Springfield, MO 65804-4224 - Phone
- (417) 890-7787
- Fax
- (417) 890-9397
- NPI assigned
- Jun 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 2004036179 | MO | Primary |
Addresses
Primary practice location
1342 E Primrose Street
Suite a
Springfield, MO 65804-4224
Mailing address
1342 E Primrose Street
Suite a
Springfield, MO 65804-4224
Phone (417) 890-7787
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1342 E Primrose St
Suite a
Springfield, MO 65804-4224
Phone (417) 890-7787
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0269 | SD | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aptitude Physical Therapy, LLC | Orthopedic | Current | Accepting new patients |
| Winner Physical Therapy Inc | Orthopedic | Past | Accepting new patients |
Locations
1342 E Primrose St
Ste A
Springfield, MO 65804
Phone (417) 877-1300
Organizations & group practices 2
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": "1212364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406505600000",
"number": "1982863353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1342 E PRIMROSE STREET",
"address_2": "SUITE A",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044224",
"telephone_number": "417-890-7787",
"fax_number": "417-890-9397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1342 E PRIMROSE STREET",
"address_2": "SUITE A",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044224",
"telephone_number": "417-890-7787",
"fax_number": "417-890-9397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "KELLY",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-02",
"last_updated": "2014-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MO",
"license": "2004036179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; 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.