Individual provider Active NPI

Stacey Lynn Cole, M.D.

  • Clinical Genetics (M.D.) Physician
  • Salt Lake City, UT
National Provider Identifier
1194154989
Registry record updated Dec 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
12985834-1205 Issued in UT
Practice address
295 S Chipeta Way
Salt Lake City, UT 84108-1287
Phone
(801) 587-7689
NPI assigned
Nov 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A156177 CA
Clinical Genetics (M.D.) Physician 207SG0201X 12985834-1205 UT Primary

Addresses

Primary practice location

295 S Chipeta Way
Salt Lake City, UT 84108-1287

Mailing address

2516 Stockton Blvd
Sacramento, CA 95817-2208

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SCOLE6493@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191203000454 CA Practitioner - Pediatric Medicine 5597198747 Reassigns benefits to 3 organizations
I20221203000284 UT Practitioner - Pediatric Medicine 5597198747 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Utah School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 213-3599

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A156177CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Pediatrics Current Accepting new patients
University of Utah Adult Services Clinical Genetics (M.D.) CurrentSince Oct 15, 2022 Accepting new patients
County of Sacramento CurrentSince Jan 1, 2020 Accepting new patients
University of Utah Adult Services Current Accepting new patients
County of Sacramento CurrentSince Jan 1, 2020 Accepting new patients
University of Utah Pediatric Services Pediatrics Current Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Sutter Valley Medical Foundation Pediatrics CurrentSince Dec 9, 2019 Accepting new patients
Regents of the University of Ca Pediatrics CurrentSince Nov 4, 2019 Accepting new patients
University of Utah Pediatric Services Clinical Genetics (M.D.) CurrentSince Oct 15, 2022 Accepting new patients
University of Utah Pediatric Services CurrentSince Oct 15, 2022 Accepting new patients
University of Utah Adult Services CurrentSince Oct 15, 2022 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Dec 9, 2019 Accepting new patients
Regents of the Univ of Ca CurrentSince Nov 4, 2019 Accepting new patients
Bronson Lakeview Hospital Pediatrics Past Accepting new patients

Locations

4600 Broadway
#1100
Sacramento, CA 95820
Phone (916) 874-9670

2521 Stockton Blvd
Ste 2200
Sacramento, CA 95817
Phone (916) 734-1180

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

4600 Broadway
Sacramento, CA 95820
Phone (916) 874-9670

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

81 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 662-5700

Interoperability endpoints

  • Direct secure messaging: scole6493@direct.med.utah.edu

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670716800000",
    "number": "1194154989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 S CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081287",
            "telephone_number": "801-587-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-02",
        "last_updated": "2022-12-11",
        "certification_date": "2022-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A156177",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "UT",
            "license": "12985834-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SCOLE6493@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.