Individual provider Active NPI

Audra Cole, D.O.

  • Obstetrics & Gynecology Physician
  • Bentonville, AR
National Provider Identifier
1104210830
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
E-12028 Issued in AR
Practice address
1200 SE 28TH St Ste 2
Bentonville, AR 72712-4641
Phone
(479) 271-0005
Fax
(479) 273-1427
NPI assigned
Mar 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X E-12028 AR Primary

Addresses

Primary practice location

1200 SE 28TH St Ste 2
Bentonville, AR 72712-4641

Mailing address

1200 SE 28TH St Ste 2
Bentonville, AR 72712-4641
Phone (479) 271-0005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190624000611 AR Practitioner - Obstetrics/Gynecology 5395079453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Oklahoma State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespring Women's Healthcare PAGroup PAC ID 1254332083, 4 clinicians

Practice addresses (Care Compare)

1200 Se28Th St
Suite 2
Bentonville, AR 72712-4641
Phone 4792710005231

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Hospital Association, Inc Obstetrics & Gynecology CurrentSince Jul 8, 2019 Accepting new patients
Lifespring Women's Healthcare PA Obstetrics & Gynecology CurrentSince Feb 1, 2021 Accepting new patients
Jefferson Hospital Association, Inc CurrentSince Jul 8, 2019 Accepting new patients

Locations

1200 SE 28th St
Ste 2
Bentonville, AR 72712
Phone (479) 271-0005

1609 W 40th Ave
Ste 201
Pine Bluff, AR 71603
Phone (870) 534-2106

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

1609 W 40th Ave
Ste 402
Pine Bluff, AR 71603
Phone (870) 534-2106

Interoperability endpoints

  • Direct secure messaging: acole714614@directa.mercy.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/GAHCDA

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 1

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": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1104210830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SE 28TH ST STE 2",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124641",
            "telephone_number": "479-271-0005",
            "fax_number": "479-273-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SE 28TH ST STE 2",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124641",
            "telephone_number": "479-271-0005",
            "fax_number": "479-273-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "AUDRA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-19",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "E-12028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.