Active NPI
Larry W Cole, M.D.
- Dermatology Physician
- Colorado Springs, CO
National Provider Identifier
1174619068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 17452
- Practice address
- 3245 International Cir
Suite 200
Colorado Springs, CO 80910-3152 - Phone
- (719) 484-8840
- Fax
- (719) 484-8845
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 17452 | CO | Primary |
Addresses
Primary practice location
3245 International Cir
Suite 200
Colorado Springs, CO 80910-3152
Mailing address
3245 International Cir
Suite 200
Colorado Springs, CO 80910-3152
Phone (719) 484-8840
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174523 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17452 | CO | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Interoperability endpoints
- larry.cole@corhio.medicity.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242864000000",
"number": "1174619068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3245 INTERNATIONAL CIR",
"address_2": "SUITE 200",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809103152",
"telephone_number": "719-484-8840",
"fax_number": "719-484-8845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3245 INTERNATIONAL CIR",
"address_2": "SUITE 200",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809103152",
"telephone_number": "719-484-8840",
"fax_number": "719-484-8845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "LARRY",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2009-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CO",
"license": "17452",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1174523",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.