Individual provider Active NPI

James Webb Cole III, MD

  • Psychiatry Physician
  • Titusville, FL
National Provider Identifier
1093868127
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME 55085 Issued in FL
Practice address
101 Dragonfly Dr
Titusville, FL 32780-2584
Phone
(772) 971-3829
NPI assigned
Jan 20, 2007
Last updated
Apr 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME 55085 FL Primary

Addresses

Primary practice location

101 Dragonfly Dr
Titusville, FL 32780-2584

Mailing address

101 Dragonfly Dr
Titusville, FL 32780-2584
Phone (772) 971-3829

Other identifiers 1

IdentifierTypeStateIssuer
062071800MedicaidFLMEDICAID PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 55085FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Nov 25, 2015 Accepting new patients
Southern Illinois Healthcare Foundation Inc Current Accepting new patients
Southern Illinois Healthcare Foundation, Inc. Psychiatry CurrentSince Nov 27, 2018 Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Nov 27, 2018 Accepting new patients
MCR Health, Inc. CurrentSince Nov 25, 2015 Accepting new patients

Locations

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

302 N Mill St
Greenup, IL 62428
Phone (217) 923-3311

1120 N East St
Olney, IL 62450
Phone (618) 395-5222

1200 N East St
Olney, IL 62450
Phone (618) 392-2940

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1093868127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DRAGONFLY DR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327802584",
            "telephone_number": "772-971-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DRAGONFLY DR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327802584",
            "telephone_number": "772-971-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "JAMES",
        "middle_name": "WEBB",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-20",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME 55085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": "MEDICAID PROVIDER NUMBER",
            "identifier": "062071800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.