Individual provider Active NPI

Tanner Grant Cole, FNP-C

  • Nurse Practitioner
  • Bridgeport, WV
National Provider Identifier
1407626567
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
107935 Issued in WV
Practice address
327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone
(681) 342-1100
NPI assigned
Jan 8, 2024
Last updated
Jun 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 107935 WV Primary

Addresses

Primary practice location

327 Medical Park Dr
Bridgeport, WV 26330-9006

Mailing address

911 Bunner Ridge Rd
Fairmont, WV 26554-5070
Phone (304) 657-6981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20240905004864 WV Practitioner - Nurse Practitioner 6800336702 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
West Virginia University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone (681) 342-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital of Buckhannon Inc CurrentSince Dec 1, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 28, 2024 Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 28, 2024 Accepting new patients
United Hospital Center, Inc. CurrentSince Sep 5, 2025 Accepting new patients
United Hospital Center Past Accepting new patients
St Josephs Hospital of Buckhannon Past Accepting new patients

Locations

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

1 Amalia Dr
Buckhannon, WV 26201
Phone (304) 473-2185

1013 N Randolph Ave
Elkins, WV 26241
Phone (681) 342-3000

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Organizations & group practices 6

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": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1407626567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 BUNNER RIDGE RD",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265545070",
            "telephone_number": "304-657-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 MEDICAL PARK DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309006",
            "telephone_number": "681-342-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "TANNER",
        "middle_name": "GRANT",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "107935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.