Individual provider Active NPI

Eric Eugene Cole, PA-C

  • Physician Assistant
  • Davenport, FL
National Provider Identifier
1255397873
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3789 Issued in AZ
Practice address
141 Webb Drive
Suite 300
Davenport, FL 33837
Phone
(863) 422-0020
Fax
(863) 422-0021
NPI assigned
Apr 22, 2006
Last updated
Jul 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3789 AZ Primary
Medical Physician Assistant 363AM0700X 3789 AZ

Addresses

Primary practice location

141 Webb Drive
Suite 300
Davenport, FL 33837

Mailing address

141 Webb Drive
Suite 300
Davenport, FL 33837
Phone (863) 422-0020

Other practice location 1

10503 W Thunderbird Blvd
Ste 262
Sun City, AZ 85351-3022
Phone (866) 974-2673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060328000289 FL Practitioner - Physician Assistant 5395753644 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
17057CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hughston Orthopaedic Southeast PC PastSince Jul 31, 2023 Accepting new patients
Orthopedic Specialists of SW Florida, P.a. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: eric.cole.p2@direct.painreliefcenters.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1255397873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 WEBB DRIVE",
            "address_2": "SUITE 300",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33837",
            "telephone_number": "863-422-0020",
            "fax_number": "863-422-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 WEBB DRIVE",
            "address_2": "SUITE 300",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33837",
            "telephone_number": "863-422-0020",
            "fax_number": "863-422-0021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10503 W Thunderbird Blvd",
            "address_2": "Ste 262",
            "address_purpose": "LOCATION",
            "city": "Sun City",
            "state": "AZ",
            "postal_code": "853513022",
            "country_code": "US",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "ERIC",
        "middle_name": "EUGENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3789",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3789",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.