Active NPI
Angel Marie Cole, CRNA
- Certified Registered Nurse Anesthetist
- Johnson City, TN
National Provider Identifier
1508138520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- APN17613
- Practice address
- 400 N State of Franklin Rd
Johnson City, TN 37604-6035 - Phone
- (423) 431-6111
- NPI assigned
- Feb 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0024169833 | VA | |
| Certified Registered Nurse Anesthetist | 367500000X | 0001237483 | VA | |
| Certified Registered Nurse Anesthetist | 367500000X | APN17613 | TN | Primary |
Addresses
Primary practice location
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Mailing address
1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone (423) 283-0776
Other practice location 1
1009 Lark St
Suite 2
Johnson City, TN 37604-8217
Phone (423) 283-0776 ext. 108
Other practice location 2
300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1532691 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024169833 | VA | MD | Nurse Practitioner |
| APN17613 | TN | MD | Certified Registered Nurse Anesthetist |
| 0001237483 | VA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Anesthesia, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Richlands, VA
- NPI 1760592323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1508138520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 NOVUS DR STE 2",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376048237",
"telephone_number": "423-283-0776",
"fax_number": "423-283-0549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N STATE OF FRANKLIN RD",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046035",
"telephone_number": "423-431-6111"
}
],
"practiceLocations": [
{
"address_1": "1009 Lark St",
"address_2": "SUITE 2",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376048217",
"country_code": "US",
"telephone_number": "423-283-0776 x108",
"fax_number": "423-283-0549",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "300 Med Tech Pkwy",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376042277",
"country_code": "US",
"telephone_number": "423-302-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLE",
"first_name": "ANGEL",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-07",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "VA",
"license": "0024169833",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "0001237483",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "APN17613",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1532691",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.