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NPI Code Detail

MEDICARE: JAMES LEE COLEMAN III

MEDICARE: JAMES LEE COLEMAN III
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1023963592
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES LEE COLEMAN III
Provider Business Mailing Address
First Line : 4478 REDMAN AVE APT P
Second Line :
City : OMAHA
State : NE
Zip : 68111-1472
Country : US
Telephone Number : 402-889-7034
Fax Number :
Provider Business Practice Location Address
First Line : 14210 ARBOR ST STE A
Second Line :
City : OMAHA
State : NE
Zip : 68144-2382
Country : US
Telephone Number : 531-999-1133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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