Individual provider Active NPI

Justin Don Cole

  • Family Nurse Practitioner
  • Broken Arrow, OK
National Provider Identifier
1790211795
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
82942 Issued in OK
Practice address
3325 S 204TH East Ave
Broken Arrow, OK 74014-5165
Phone
(918) 955-1907
NPI assigned
May 11, 2017
Last updated
May 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

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 82942 OK Primary

Addresses

Primary practice location

3325 S 204TH East Ave
Broken Arrow, OK 74014-5165

Mailing address

2000 S Wheeling Ave Ste 701
Tulsa, OK 74104-5647
Phone (918) 748-7810

Other practice location 1

1232 SW 89th St
Oklahoma City, OK 73139-9105
Phone (405) 879-3470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20171018001851 OK Practitioner - Nurse Practitioner 8729354790 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HIV Resource Consortium, Inc.Group PAC ID 7416389200, 4 clinicians

Practice addresses (Care Compare)

3712 E 11TH St
Tulsa, OK 74112-3952
Phone (918) 834-4194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Oct 8, 2017 Accepting new patients
St. John Physicians, Inc. Current Accepting new patients
HIV Resource Consortium, Inc. CurrentSince Jan 6, 2024 Accepting new patients
At Home by Choice Inc. CurrentSince Aug 7, 2023 Accepting new patients
Choice Hospice, Inc PastSince Sep 20, 2022 Accepting new patients

Locations

1232 SW 89th St
Oklahoma City, OK 73139
Phone (405) 879-3460

1232 SW 89th St
Ste A
Oklahoma City, OK 73139
Phone (405) 879-3470

1232 SW 89th St
Ste C
Oklahoma City, OK 73139
Phone (405) 879-3470

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

3712 E 11th St
Tulsa, OK 74112
Phone (918) 691-7133

3714 E 11th St
Tulsa, OK 74112
Phone (918) 834-4194

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1790211795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE STE 701",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045647",
            "telephone_number": "918-748-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 S 204TH EAST AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740145165",
            "telephone_number": "918-955-1907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1232 SW 89th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731399105",
            "country_code": "US",
            "telephone_number": "405-879-3470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "JUSTIN",
        "middle_name": "DON",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "82942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.