Individual provider Active NPI

Conrad R Cole, MD

  • Pediatric Gastroenterology Physician
  • Gainesville, FL
National Provider Identifier
1700828464
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
ME167918 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3026
Phone
(352) 273-9350
Fax
(352) 273-9055
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 052907 GA
Pediatric Gastroenterology Physician 2080P0206X 35-078856 OH
Pediatric Gastroenterology Physician 2080P0206X ME167918 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3026

Mailing address

PO Box 100296
Gainesville, FL 32610-0296
Phone (352) 273-9350

Other practice location 1

3333 Burnet Avenue MLC 2010
Cincinnati Children's Hospital
Cincinnati, OH 45229-3026
Phone (513) 636-4415

Other identifiers 1

IdentifierTypeStateIssuer
363382413AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100708000976 OH Practitioner - GastroenterologyPractitioner - Pediatric Medicine 2769466374 Reassigns benefits to 1 organization
I20240712001609 FL Practitioner - Pediatric MedicinePractitioner - Gastroenterology 2769466374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Gastroenterology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Clinical Practice Association IncGroup PAC ID 0345146254, 1,886 clinicians

Practice addresses (Care Compare)

1535 Gale Lemerand Dr
Gainesville, FL 32610-3008
Phone (352) 273-9500

1549 Gale Lemerand Dr
Gainesville, FL 32610-3008
Phone (352) 265-4357

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-078856OHMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jul 15, 2024 Accepting new patients
Children'S Hospital Medical Center CurrentSince Apr 8, 2015 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 15, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Emory Childrens Center Past Accepting new patients

Locations

1549 Gale Lemerand Dr
Gainesville, FL 32610
Phone (352) 265-0496

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
#2010
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

Interoperability endpoints

  • Direct secure messaging: ccole720724@direct.shands.ufl.edu

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1700828464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100296",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100296",
            "telephone_number": "352-273-9350",
            "fax_number": "352-273-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103026",
            "telephone_number": "352-273-9350",
            "fax_number": "352-273-9055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Burnet Avenue MLC 2010",
            "address_2": "Cincinnati Children's Hospital",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293026",
            "country_code": "US",
            "telephone_number": "513-636-4415",
            "fax_number": "513-636-7805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "CONRAD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "GA",
            "license": "052907",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OH",
            "license": "35-078856",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME167918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363382413A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.