Individual provider Active NPI

Mary T. Cole, DMD

  • General Practice Dentistry
  • Decatur, IL
National Provider Identifier
1710031380
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
2727 N Oakland Ave
Suite 101
Decatur, IL 62526-1586
Phone
(217) 877-1743
Fax
(217) 877-9399
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

2727 N Oakland Ave
Suite 101
Decatur, IL 62526-1586

Mailing address

2727 N Oakland Ave
Suite 101
Decatur, IL 62526-1586
Phone (217) 877-1743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160301001838 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2163727090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019026267ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald N Cole DMD PC General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710031380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 N OAKLAND AVE",
            "address_2": "SUITE 101",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261586",
            "telephone_number": "217-877-1743",
            "fax_number": "217-877-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 N OAKLAND AVE",
            "address_2": "SUITE 101",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261586",
            "telephone_number": "217-877-1743",
            "fax_number": "217-877-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "MARY",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.