MEDICARE: DR. JORDAN ALYSE COFFELT AU.D.

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
1	231H00000X	Audiologist	426	AR
2	231H00000X	Audiologist	A4402	MS
3	231H00000X	Audiologist	1761	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134673643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORDAN ALYSE COFFELT AU.D.

Provider Business Mailing Address
First Line	:	4055 N PARK LOOP
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38152-4220
Country	:	US
Telephone Number	:	901-678-2009
Fax Number	:	901-678-5497

Provider Business Practice Location Address
First Line	:	4055 N PARK LOOP
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38152-4220
Country	:	US
Telephone Number	:	901-678-2009
Fax Number	:	901-678-5497

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2016
Last Update Date	:	08/19/2020

Similar Medicare Providers

1609961655 — THE UNIVERSITY OF MEMPHIS
Practice Location Address:

4055 N PARK LOOP STE 1004
MEMPHIS, TN
38152-4220

Practice Phone: 901-678-2009
Practice Fax: 901-678-5497

1245786342 — HERBERT JAY GOULD PH.D.
Practice Location Address:

4055 N PARK LOOP
MEMPHIS, TN
38152-4220

Practice Phone: 901-678-5800
Practice Fax: 901-678-5497

1508366436 — CAITLIN ELISE NELMS PRICE AUD
Practice Location Address:

4055 N PARK LOOP
MEMPHIS, TN
38152-4220

Practice Phone: 901-678-2009
Practice Fax:

1225695729 — ANNIE CORNELIUS MS, BCBA, LBA
Practice Location Address:

4005 N PARK LOOP
MEMPHIS, TN
38152-4220

Practice Phone: 901-834-7312
Practice Fax:

1669016192 — TAWNI BALLINGER SLP
Practice Location Address:

4055 N PARK LOOP
MEMPHIS, TN
38152-4220

Practice Phone: 901-678-2009
Practice Fax:

1437798659 — KELLI OWENS SLP
Practice Location Address:

4055 N PARK LOOP
MEMPHIS, TN
38152-4220

Practice Phone: 901-678-2009
Practice Fax: 901-678-5497

Directions to “ DR. JORDAN ALYSE COFFELT AU.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.