Individual provider Active NPI

Sherri Alaine Cole, L.D.O.

  • Optician
  • Lake City, FL
National Provider Identifier
1235359258
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO4171 Issued in FL
Practice address
621 SW Baya Dr
Suite 101
Lake City, FL 32025-4240
Phone
(386) 719-9292
Fax
(386) 754-6615
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X DO4171 FL Primary

Addresses

Primary practice location

621 SW Baya Dr
Suite 101
Lake City, FL 32025-4240

Mailing address

241 SE Oak St
Lake City, FL 32025-6841
Phone (386) 623-0514

Other identifiers 1

IdentifierTypeStateIssuer
630349800MedicaidFL

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DO4171FLMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235359258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 SE OAK ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256841",
            "telephone_number": "386-623-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SW BAYA DR",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320254240",
            "telephone_number": "386-719-9292",
            "fax_number": "386-754-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "SHERRI",
        "middle_name": "ALAINE",
        "name_prefix": "Mrs.",
        "credential": "L.D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO4171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630349800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.