1194841981 NPI number — MR. RONALD COLE PT

Table of Contents

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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