Cole Jeavons, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA6927 Issued in MS

Practice address

1414 Hospital St
Greenville, MS 38703-3217

Phone

(601) 946-0312

NPI assigned

Mar 24, 2021

Last updated

Mar 24, 2021By the provider in NPPES

Sex

Male

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1275110603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W 13TH AVE UNIT 820",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802042728",
            "telephone_number": "601-946-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 HOSPITAL ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387033217",
            "telephone_number": "601-946-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAVONS",
        "first_name": "COLE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "PTA6927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "PTA6927",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Greenville",
            "affiliation": "N",
            "endpointDescription": "Pt communications are charted in charting system",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Greenville",
            "address_1": "1414 Hospital St",
            "city": "Greenville",
            "state": "MS",
            "country_code": "US",
            "postal_code": "387033217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul D Jackson, MD
• Richard Jackson, MD
• Dhruvkumar Narendrasinh Jadav, MD
• James R Parkerson, Jr, DDS, PA
• Jean Barker MD Inc
• Shamekia Lavette Jenkins-McCain
• Chester W Jenkins, MD
• Elizabeth Jenkins
• Jessica Joy Jenkins, MD
• Tashaka Jenkins

• Physical Therapy Assistant in Greenville, MS
• Providers in Greenville, MS by specialty
• Physical Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.