1194841981 NPI number — MR. RONALD COLE PT

Table of content: MR. RONALD COLE PT (NPI 1194841981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194841981 NPI number — MR. RONALD COLE PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLE
Provider First Name:
RONALD
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194841981
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11901 SHELBYVILLE RD
Provider Second Line Business Mailing Address:
SUITE 125
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40243-1077
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-499-5559
Provider Business Mailing Address Fax Number:
502-499-5399

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11901 SHELBYVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 125
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40243-1077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-499-5559
Provider Business Practice Location Address Fax Number:
502-499-5399
Provider Enumeration Date:
03/22/2007

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: 225100000X , with the licence number:  003879 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6400230 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 87000303 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1148472 . This is a "PASSPORT PIN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: SCL 3300381 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00000019024 . This is a "ANTHEM PLANS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 27237 . This is a "BLUEGRASS FAMILY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 2438452 . This is a "PASSPORT ADVANTAGE PIN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 6218148181 . This is a "HUMANA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 6414987 . This is a "UHC ALL OTHER PLANS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7431202 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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