SHANE M COLEMAN (NPI# 1083819692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083819692 |
| Entity Type | Individual |
| Full Name | SHANE M COLEMAN |
| Credential | M.D., MPH |
| Practice Address |
4320 Diplomacy Dr Suite 1500 Anchorage AK 99508-5925 |
| Practice Telephone | 9077292500 |
| Practice Fax Number | 9077298972 |
| Mailing Telephone | 9077292500 |
| Mailing Fax Number | 9077298972 |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2013-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
7728 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MEDICAL TRAINING/LIMITED LICENSE | 232258 | 01 |
| AK | MEDICAL LICENS | 7728 | 01 |
| WA | MEDICAL LICENSE | MD60212882 | 01 |
| AK | ALASKA MEDICAID PROVIDER NUMBER | MD00372 | 01 |
| MA | MEDICAL LICENSE | 246201 | 01 |
| AK | MEDICAL LICENSE - TEMP | 6810 | 01 |
| WA | 1083819 | 05 |
| Street Address |
4320 DIPLOMACY DR SUITE 1500 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536104 | Cynthia Aguiar | Pharmacist | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2005-05-24 |
| 1164023594 | Stacie Ann Williamson | Counselor | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-11-03 |
| 1235739590 | Tiffany Ma | Pharmacist | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-10-27 |
| 1124627922 | Southcentral Foundation | Pharmacy | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-10-22 |
| 1689281834 | Jessica Anahy Martinez | Counselor | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-09-30 |
| 1801400494 | Ariel Nicole Moilanen | Counselor | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-09-01 |
| 1407466386 | Timothy Lee Griffin | Counselor | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-08-05 |
| 1073122065 | Kobe Keo Liftee Thammavongsa | Registered Nurse | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-07-27 |
| 1225653041 | Destiny Steward | Behavior Technician | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-06-09 |
| 1003430240 | Edward Washington II | Counselor | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2020-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942781562 | Anchorage Psychiatry | Psychiatry & Neurology | 1120 Huffman Rd Ste 24, Anchorage, AK 99515-3516 | 2018-08-22 |
| 1821453937 | Dr, Deborah Guris LLC | Psychiatry & Neurology | 15630 Stanwood Cir, Anchorage, AK 99516-4866 | 2015-12-17 |
| 1225378664 | Shirley Ann Saucerman | Psychiatry & Neurology | 336 W 10th Ave, Anchorage, AK 99501-3501 | 2013-02-21 |
| 1336408335 | Melinda M Hansen | Psychiatry & Neurology | 4501 Diplomacy Drive, Southcentral Foundation, Anchorage, AK 99508-0000 | 2012-05-10 |
| 1548420920 | Willow, LLC | Psychiatry & Neurology | 920 E 72nd Ave, Anchorage, AK 99518-2810 | 2008-06-10 |
| 1992987655 | Jonathan Benaknin | Psychiatry & Neurology | Anchorage Native Primary Care Center, 4320 Diplomacy Drive, Anchorage, AK 99508 | 2007-12-04 |
| 1548452519 | Clare Louise Maxwell | Psychiatry & Neurology | 1231 Gambell St Ste 300, Anchorage, AK 99501 | 2007-08-14 |
| 1447441944 | Jay Hugh Ehly | Psychiatry & Neurology | 200 W 34th Ave, Pmb 1204, Anchorage, AK 99503-3969 | 2007-08-08 |
| 1609070374 | Sarah Tighe Mccutcheon | Psychiatry & Neurology | Greatland Clinical Associates, 1400 W Benson Blvd Ste 315, Anchorage, AK 99503 | 2007-06-14 |
| 1881727923 | Wandal William Winn | Psychiatry & Neurology | 4300 B St Ste 202, Anchorage, AK 99503-5951 | 2007-03-14 |
| Find all providers in ANCHORAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.