Active NPI
John Martin Cole III, LPTA
- Physical Therapy Assistant
- Eureka, CA
National Provider Identifier
1609135227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 8187123-2402
- Practice address
- 6400 Purdue Dr
Eureka, CA 95503-7095 - Phone
- (707) 443-5668
- NPI assigned
- May 16, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 8187123-2402 | UT | Primary |
| Physical Therapy Assistant | 225200000X | PTA6341 | AL |
Addresses
Primary practice location
6400 Purdue Dr
Eureka, CA 95503-7095
Mailing address
854 Forest Lake Dr S
Macon, GA 31210-3214
Phone (706) 577-6849
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA6341 | AL | MD | Physical Therapy Assistant |
| 8187123-2402 | UT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337126400000",
"number": "1609135227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "854 FOREST LAKE DR S",
"city": "MACON",
"state": "GA",
"postal_code": "312103214",
"telephone_number": "706-577-6849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6400 PURDUE DR",
"city": "EUREKA",
"state": "CA",
"postal_code": "955037095",
"telephone_number": "707-443-5668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "JOHN",
"middle_name": "MARTIN",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-16",
"last_updated": "2012-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "UT",
"license": "8187123-2402",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AL",
"license": "PTA6341",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.