Individual provider Active NPI

Richard Clinton Cole, MD

  • Family Medicine Physician
  • Tullahoma, TN
National Provider Identifier
1578558441
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD021619 Issued in TN
Practice address
2106 N Jackson St
Tullahoma, TN 37388-2208
Phone
(931) 455-2045
Fax
(931) 455-9960
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD021619 TN Primary

Addresses

Primary practice location

2106 N Jackson St
Tullahoma, TN 37388-2208

Mailing address

2106 N Jackson St
Tullahoma, TN 37388-2208
Phone (931) 455-2045

Other identifiers 3

IdentifierTypeStateIssuer
3145745MedicaidTN
3707865MedicaidTN
3145745OtherTNBLUE CROSS BLUE SHIELD TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20060427000654 TN Practitioner - Family Practice 2365344876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 1983
Medicare assignment
May accept Medicare assignment
Group practices
Spectrum Medical AssociatesGroup PAC ID 0749182251, 3 clinicians

Practice addresses (Care Compare)

2106 N Jackson St
Tullahoma, TN 37388-2208
Phone (931) 455-2045

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD021619TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Medical Associates Family Medicine CurrentSince Jun 1, 2000 Accepting new patients
Tullahoma Hma LLC Past Accepting new patients
Tullahoma Hma, LLC Past Accepting new patients

Locations

2106 N Jackson St
Tullahoma, TN 37388
Phone (931) 434-6865

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 5

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1578558441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882208",
            "telephone_number": "931-455-2045",
            "fax_number": "931-455-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882208",
            "telephone_number": "931-455-2045",
            "fax_number": "931-455-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "RICHARD",
        "middle_name": "CLINTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD021619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3145745",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3707865",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "3145745",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.