DR. GERARD JOHN-CHARLES COUGHLIN DPM RESIDENT
NPI 1104457159
Student in an Organized Health Care Education/Training Program in Greeley, CO

Q: What is Gerard Coughlin's NPI number?

The NPI number for Gerard Coughlin is 1104457159. It was assigned to this individual provider in the NPPES registry on January 29, 2020.

Q: What is Gerard Coughlin's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Gerard Coughlin was last updated on May 17, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 29, 2020PECOS Enrolled

1600 23RD AVE, GREELEY, CO 80634(970) 810-2847(970) 810-2820 Get Directions Write a Review

NPPES record last updated: May 17, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 17, 2023, May 11, 2023, Jan 29, 2020 (3 updates tracked since 2020).

On this page

About Dr. Gerard John-charles Coughlin Dpm Resident NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GERARD JOHN-CHARLES COUGHLIN DPM RESIDENT (NPI 1104457159) is an individual student in an organized health care education/training program in Greeley, Colorado, licensed in Colorado (PDT.0000615) and active in the NPI registry since January 2020. He is enrolled in Medicare PECOS and maintains a secondary practice location in Oakland.

NPPES Registry Identity

NPI1104457159

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. GERARD JOHN-CHARLES COUGHLINCredential: DPM RESIDENT

Location Address1600 23RD AVEGreeley, CO 80634-6070

Mailing Address1600 23rd AveGreeley, CO 80634-6070

Phone(970) 810-2847

Fax(970) 810-2820

Sole ProprietorYes

Enumeration DateJanuary 29, 2020

Last NPPES UpdateMay 17, 20233 updates tracked since enumeration

NPPES CertifiedMay 17, 2023

✔ NPI 1104457159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in CO · PDT.0000615

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1600 23RD AVE, Greeley, CO 80634

Open in Google Maps ↗

Secondary Practice Location 1

Location 1Samuel Merritt University, 3100 Telegraph AvenueOakland, CA 94609 · Phone (805) 437-9742

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Gerard John-charles Coughlin Dpm Resident is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.