Individual provider Active NPI

Cole Weston Ross

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1720762974
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023021732 Issued in MO
Practice address
1723 Broadway St Ste 410
Cape Girardeau, MO 63701-4556
Phone
(573) 332-7746
NPI assigned
Jun 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2023021732 MO Primary

Addresses

Primary practice location

1723 Broadway St Ste 410
Cape Girardeau, MO 63701-4556

Mailing address

1637 Themis St
Cape Girardeau, MO 63701-5221
Phone (573) 803-8346

Other practice location 1

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 334-4822

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230706001605 MO Practitioner - Nurse Practitioner 7618336892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Facilities Rehab Services IncGroup PAC ID 3476679226, 152 clinicians
Regional Brain and Spine LLCGroup PAC ID 0749237808, 11 clinicians

Practice addresses (Care Compare)

1102 Sikes Ave
Sikeston, MO 63801-5021

1723 Broadway St
Suite 410
Cape Girardeau, MO 63701-4556
Phone (573) 332-7746

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023021732MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Brain & Spine LLC CurrentSince Jul 3, 2023 Accepting new patients
Regional Brain & Spine LLC CurrentSince Jul 3, 2023 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1723 Broadway St
Ste 410
Cpe Girardeau, MO 63701
Phone 5733327746106

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23947/brand/1/csg/1/fhir/r4
  • Direct secure messaging: cole.ross.1@23947.direct.athenahealth.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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1720762974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 THEMIS ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637015221",
            "telephone_number": "573-803-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST STE 410",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014556",
            "telephone_number": "573-332-7746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Lacey St",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637015230",
            "country_code": "US",
            "telephone_number": "573-334-4822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "COLE",
        "middle_name": "WESTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023021732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.