1811267248 NPI number — CLAIRE G COATES MS, AT, ATC

Table of content: CHRIS SINGER RRT (NPI 1184053126)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811267248 NPI number — CLAIRE G COATES MS, AT, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COATES
Provider First Name:
CLAIRE
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, AT, ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GRAVES
Provider Other First Name:
CLAIRE
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1811267248
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6664 BUCK XING
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YPSILANTI
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48197-6838
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-524-0073
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 S STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-763-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/02/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 246Z00000X , with the licence number:  2601001247 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2255A2300X , with the licence number: AL 2717 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2000001652 . This is a "NATIONAL ATHLETIC TRAINERS' BOARD OF CERTIFICATION, INC." identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".