Ezra Lee Cole, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E8536 Issued in AR

Practice address

1101 N Progress Ave
Siloam Springs, AR 72761-4343

Phone

(479) 549-4228

Fax

(479) 549-3711

NPI assigned

Apr 16, 2010

Last updated

Feb 13, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR, OK2 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

Specialty

Pediatric MedicineAlso: Internal Medicine

Education

University of Arkansas College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Francis House Nwa, Inc.Group PAC ID 0042262495, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Francis House Nwa, Inc

  dba Community Clinic West Fork

  • Federally Qualified Health Center (FQHC)
  • West Fork, AR
  • NPI 1336986785
  Medicare reassignment Care Compare group NPD
• St Francis House Nwa, Inc

  dba Advanced Health & Wellness I

  • Federally Qualified Health Center (FQHC)
  • Fayetteville, AR
  • NPI 1700650249
  NPD
• St. Francis House Nwa, Inc.

  dba Community Clinic Rogers Medical

  • Federally Qualified Health Center (FQHC)
  • Rogers, AR
  • NPI 1710160098
  NPD (past)
• Ahs Oklahoma Physician Group, LLC

  dba Cushing Medical Specialist

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051
  NPD (past)

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1851617757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727610516",
            "telephone_number": "479-549-4228",
            "fax_number": "479-549-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N PROGRESS AVE",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727614343",
            "telephone_number": "479-549-4228",
            "fax_number": "479-549-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "EZRA",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-16",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E8536",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E8536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200303500B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203868001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Clyne
• Whitly Nicole Cochran, LAC
• Jacob Cazort Cockcroft, M.S., CF-SLP
• Chelsea Kaitlyn Coffelt
• Sloane Audie Coffey, LAC
• Jack Andrew Coleman Jr., MD
• Mary A Coleman, RN
• Veronica Yamilet Collier, COTA/L
• Cheryl Raye Comfort
• Tauri Rose Cooley

• Pediatrics Physician in Siloam Springs, AR
• Providers in Siloam Springs, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.