Active NPI
Justin L Cole, NP
- Gerontology Nurse Practitioner
- Laurel, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 885111
- Practice address
- 1203 Jefferson St
Laurel, MS 39440-4354 - Phone
- (601) 649-2863
- Fax
- (601) 649-9479
- NPI assigned
- Jan 21, 2015
- Last updated
- Sep 25, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R885111 | MS | |
| Gerontology Nurse Practitioner | 363LG0600X | 885111 | MS | Primary |
Addresses
Primary practice location
1203 Jefferson St
Laurel, MS 39440-4354
Mailing address
PO Box 23666
Jackson, MS 39225-3666
Phone (601) 200-4560
Other practice location 1
971 Lakeland Dr Ste 557
Jackson, MS 39216-4661
Phone (601) 200-4560
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jcole2546020@direct.casso.us.com | Direct | |
| FHIR URL | https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
106 Highland Way
Madison, MS 39110-6933
971 Lakeland Dr
Suite 557
Jackson, MS 39216-4661
Phone (601) 200-4560
Hospital & facility affiliations
- St Dominic-Jackson Memorial Hospital
- King's Daughters Medical Center-Brookhaven
- South Central Reg Med Ctr
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.09 of 100
- Quality
- 73.43
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R885111 | MS | MD | Nurse Practitioner |
| 885111 | MS | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Dominic Medical Associates LLC | Current | Accepting new patients | |
| St. Dominic Medical Associates LLC | Current | Accepting new patients | |
| Jefferson Neurology Clinic, LLC | Current | Accepting new patients | |
| St Dominic Medical Associates LLC | Past | Accepting new patients |
Locations
971 Lakeland Dr
Ste 557
Jackson, MS 39216
Phone (601) 200-4560
319 S 13th Ave
Laurel, MS 39440
Phone (601) 426-2140
106 Highland Way
Ste 202
Madison, MS 39110
Phone (601) 200-3376
Interoperability endpoints
- jcole2546020@direct.casso.us.com
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Jackson, MS
- NPI 1407920549
-
- Clinic/Center
- Laurel, MS
- NPI 1518486943
-
dba St Dominic Pallative Care
- Hospitalist Physician
- Jackson, MS
- NPI 1285987578
-
dba St. Dominic Family Practice Associates-Jackson
- Family Nurse Practitioner
- Jackson, MS
- NPI 1508263179
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brookhaven, MS
- NPI 1972503464
-
- General Acute Care Hospital
- Laurel, MS
- NPI 1619973542
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1306876065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758758400000",
"number": "1588053052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23666",
"city": "JACKSON",
"state": "MS",
"postal_code": "392253666",
"telephone_number": "601-200-4560",
"fax_number": "601-200-4580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1203 JEFFERSON ST",
"city": "LAUREL",
"state": "MS",
"postal_code": "394404354",
"telephone_number": "601-649-2863",
"fax_number": "601-649-9479"
}
],
"practiceLocations": [
{
"address_1": "971 Lakeland Dr Ste 557",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392164661",
"country_code": "US",
"telephone_number": "601-200-4560",
"fax_number": "601-200-4580",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLE",
"first_name": "JUSTIN",
"middle_name": "L",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-21",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "R885111",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MS",
"license": "885111",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jcole2546020@direct.casso.us.com",
"affiliation": "N",
"endpointDescription": "FMOLHS-EPIC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "jcole2546020@direct.casso.us.com",
"address_1": "971 Lakeland Dr Ste 557",
"city": "Jackson",
"state": "MS",
"country_code": "US",
"postal_code": "392164661",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FMOLHS FHIR URL",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "971 Lakeland Dr Ste 557",
"city": "Jackson",
"state": "MS",
"country_code": "US",
"postal_code": "392164661",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Laurel, MS
- Rushie Clayton, LCSW
- CLC of Laurel, LLC (Laurelwood Community Living Center)
- Jackie Coats, LSW
- Cohen Podiatry Clinic (Cohen Podiatry Clinic Laurel)
- Jenna Kay Cole, FNP-BC
- Coleman Transit
- Collins and Collins I LLC (CCI Professional Healthcare Hospice)
- George G Collins Jr., P.T.
- Community Care Center of Laurel, LLC (Care Center of Laurel)
- Benjamin Hardee Cooley, P.T.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.