Active NPI
Phelan Cole, DPT
- Physical Therapist
- Riverside, CA
National Provider Identifier
1598015463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 39416
- Practice address
- 6180 Brockton Ave
Ste 101
Riverside, CA 92506-2228 - Phone
- (951) 781-6653
- Fax
- (951) 275-0159
- NPI assigned
- Sep 18, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 39416 | CA | Primary |
Addresses
Primary practice location
6180 Brockton Ave
Ste 101
Riverside, CA 92506-2228
Mailing address
6180 Brockton Ave
Ste 101
Riverside, CA 92506-2228
Phone (951) 781-6653
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39416 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benchmark Therapy, Inc. | 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.
-
- Physical Therapy Clinic/Center
- Duncansville, PA
- NPI 1457365439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347926400000",
"number": "1598015463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6180 BROCKTON AVE",
"address_2": "STE 101",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062228",
"telephone_number": "951-781-6653",
"fax_number": "951-275-0159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6180 BROCKTON AVE",
"address_2": "STE 101",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062228",
"telephone_number": "951-781-6653",
"fax_number": "951-275-0159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "PHELAN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-18",
"last_updated": "2012-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "39416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.