Individual provider Active NPI

Cole Jackson Houston, MD

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1396036463
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
148047 Issued in CA
Practice address
4033 3Rd Ave Ste 400
San Diego, CA 92103-2140
Phone
(888) 883-8658
Fax
(888) 606-1317
NPI assigned
Apr 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 148047 CA Primary
Emergency Medicine Physician 207P00000X 51823 TN
Family Medicine Physician 207Q00000X 51823 TN
Student in an Organized Health Care Education/Training Program 390200000X TN

Addresses

Primary practice location

4033 3Rd Ave Ste 400
San Diego, CA 92103-2140

Mailing address

4033 3Rd Ave Ste 400
San Diego, CA 92103-2140
Phone (888) 883-8658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170512001204 CA Practitioner - Family PracticePractitioner - Emergency Medicine 6002062908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone (909) 883-8711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
148047CAMDFamily Medicine Physician
51823TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Emergency Physicians Medical Group Emergency Medicine CurrentSince Feb 1, 2019 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince May 1, 2017 Accepting new patients
Cep America-California Emergency Medicine CurrentSince May 1, 2017 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

3865 Jackson St
Riverside, CA 92503
Phone (909) 688-2211

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

4401 W Memorial Rd
Ste 121
Oklahoma City, OK 73134
Phone (405) 749-4560

Organizations & group practices 5

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 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": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1396036463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 3RD AVE STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032140",
            "telephone_number": "888-883-8658",
            "fax_number": "888-606-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 3RD AVE STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032140",
            "telephone_number": "888-883-8658",
            "fax_number": "888-606-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "COLE",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-25",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "148047",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "51823",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "51823",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.