Individual provider Active NPI

Kareem Joshua George Cole, PA-C

  • Physician Assistant
  • Rome, GA
National Provider Identifier
1063259240
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12700 Issued in GA
Practice address
1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone
(762) 235-2100
Fax
(706) 236-6432
NPI assigned
Jul 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12700 GA Primary

Addresses

Primary practice location

1825 Martha Berry Blvd NW
Rome, GA 30165-1625

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369
Phone (762) 235-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250201000226 GA Practitioner - Physician Assistant 3173052313 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Floyd Physicians LLCGroup PAC ID 6406852375, 62 clinicians

Practice addresses (Care Compare)

1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone (762) 235-2100

304 Turner McCall Blvd SW
Rome, GA 30165-5621
Phone (706) 509-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12700GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin Clinic, LLC CurrentSince Jan 1, 2025 Accepting new patients
Harbin Clinic, LLC Current Accepting new patients

Locations

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

101 Redmond Rd NW
Rome, GA 30165
Phone (706) 290-1330

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

Interoperability endpoints

  • Direct secure messaging: kcole2957470@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1063259240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651625",
            "telephone_number": "762-235-2100",
            "fax_number": "706-236-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "KAREEM",
        "middle_name": "JOSHUA GEORGE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-13",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.