Cheralaine E. Cole Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00766 Issued in TX

Practice address

1400 N Westmoreland Rd
Deharo-Saldivar Health Center
Dallas, TX 75211-1656

Phone

(214) 266-0500

Fax

(214) 266-0554

NPI assigned

Dec 6, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1801870423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N WESTMORELAND RD",
            "address_2": "DEHARO-SALDIVAR HEALTH CENTER",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752111656",
            "telephone_number": "214-266-0500",
            "fax_number": "214-266-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE JOHNSON",
        "first_name": "CHERALAINE",
        "middle_name": "E.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060352404",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060352405",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060352402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8N4452",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060352403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tony Duvall Colbert, COA
• Blake Colburn, M.S., CCC-SLP
• Victoria Nicole Colburn, SLP-ASSISTANT
• James L Colclasure, LPC
• Amanda Coldren, CO
• Cole Wellness Center
• Constance Michelle Cole-Scott, LCSW
• Alexander Gordon Cole, M.D.
• Amy Dotson Cole, LPC
• Andrew Travis Cole, M.D, M.P.H.

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.