Michelle Denise Cole, KCSA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

29422 Issued in KY

Practice address

3240 Mount Moriah Ave
Owensboro, KY 42303-7805

Phone

(270) 686-6168

Fax

(270) 686-6140

NPI assigned

May 2, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Balanced Life Primary Care, LLC

  • Family Nurse Practitioner
  • Owensboro, KY
  • NPI 1639561806
  NPD (past)

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1235305905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 MOUNT MORIAH AVE",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423037805",
            "telephone_number": "270-686-6168",
            "fax_number": "270-686-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 MOUNT MORIAH AVE",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423037805",
            "telephone_number": "270-686-6168",
            "fax_number": "270-686-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "MICHELLE",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "KCSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-02",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "29422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64294226",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coexist Counseling and Consulting, LLC
• James Cohlmeyer, MA
• Katy Nicole Coin
• Riyonna Coker
• Darby Cole, M.D.
• Christy Lynn Coleman, APRN
• Mackenzie Collier
• Andrew J Collins, DO
• Julie Ann Combs
• Commonwealth Connections

• Surgical Physician Assistant in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Surgical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.