Individual provider Active NPI

Justin Andrew Coles, MD

  • Student in an Organized Health Care Education/Training Program
  • Palmyra, VA
National Provider Identifier
1336767391
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
33 Rebecca Dr
Palmyra, VA 22963-6242
Phone
(434) 654-4680
NPI assigned
Jul 7, 2020
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101287181 VA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

33 Rebecca Dr
Palmyra, VA 22963-6242

Mailing address

33 Rebecca Dr
Palmyra, VA 22963-6242
Phone (434) 654-4680

Other practice location 1

2600 6th St SW
Canton, OH 44710-1702
Phone (330) 363-6223

Other names 1

  • Justin Coles Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251217001829 VA Practitioner - Internal Medicine 3779980214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians

Practice addresses (Care Compare)

33 Rebecca Dr
Palmyra, VA 22963-6242
Phone (434) 654-4680

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101287181VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Medical Group LLC Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Martha Jefferson Hospital PastSince Aug 10, 2025 Accepting new patients

Locations

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

33 Rebecca Dr
Palmyra, VA 22963
Phone (434) 654-4680

Interoperability endpoints

  • Direct secure messaging: jcoles1079450@direct.sentara.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1336767391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 REBECCA DR",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229636242",
            "telephone_number": "434-654-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 REBECCA DR",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229636242",
            "telephone_number": "434-654-4680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 6th St SW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447101702",
            "country_code": "US",
            "telephone_number": "330-363-6223",
            "fax_number": "330-363-3877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLES",
        "first_name": "JUSTIN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-07",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101287181",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTIN",
            "last_name": "COLES",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Palmyra, VA

Sources for this page

Verify at the official NPI Registry.