Individual provider Active NPI

Justin Garrett Cole, MD

  • Family Medicine Physician
  • Casa Grande, AZ
National Provider Identifier
1366068413
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
70114 Issued in AZ
Practice address
1811 E McMurray Blvd
Casa Grande, AZ 85122-5404
Phone
(520) 374-6530
NPI assigned
Jun 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL84326 SC
Family Medicine Physician 207Q00000X 70114 AZ Primary

Addresses

Primary practice location

1811 E McMurray Blvd
Casa Grande, AZ 85122-5404

Mailing address

1811 E McMurray Blvd
Casa Grande, AZ 85122-5404
Phone (520) 374-6530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230814002322 AZ Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 4880056456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Indiana University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

1811 E McMurray Blvd
Casa Grande, AZ 85122-5404
Phone (520) 374-6530

Hospital & facility affiliations

  • Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
  • Assisted Home Health Home health agency, Phoenix, AZ, CCN 037220
  • Banner Casa Grande Medical Center Hospital, Casa Grande, AZ, CCN 030016

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL84326SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Aug 27, 2023 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Aug 27, 2023 Accepting new patients
Banner Primary Care Physicians Arizona LLC Past Accepting new patients

Locations

1780 E Florence Blvd
Ste 108
Casa Grande, AZ 85122
Phone (520) 381-6090

1811 E McMurray Blvd
Casa Grande, AZ 85122
Phone (520) 374-2090

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1366068413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 E MCMURRAY BLVD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225404",
            "telephone_number": "520-374-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 E MCMURRAY BLVD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225404",
            "telephone_number": "520-374-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "JUSTIN",
        "middle_name": "GARRETT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-24",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL84326",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "70114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.