Individual provider Active NPI

Cole William Hensley, MD

  • Emergency Medicine Physician
  • Mount Clemens, MI
National Provider Identifier
1851973820
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
330640 Issued in NY
Practice address
1000 Harrington St
Mount Clemens, MI 48043-2920
Phone
(586) 790-9003
NPI assigned
Apr 28, 2021
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
Emergency Medicine Physician 207P00000X 01093770A IN
Emergency Medicine Physician 207P00000X 330640 NY Primary

Addresses

Primary practice location

1000 Harrington St
Mount Clemens, MI 48043-2920

Mailing address

1000 Harrington St
Mount Clemens, MI 48043-2920
Phone (586) 790-9003

Other identifiers 1

IdentifierTypeStateIssuer
0060457MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SD2 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

Enrollment IDStateProvider typePAC IDDetails
I20240711001482 NY Practitioner - Emergency Medicine 8022410950 Reassigns benefits to 1 organization
I20250604000539 SD Practitioner - Emergency Medicine 8022410950 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
330640NYMDSchool Registered Nurse
01093770AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince May 1, 2025 Accepting new patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Avera McKennan CurrentSince May 1, 2025 Accepting new patients
Buffalo Emergency Associates LLP Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

6515 Stellhorn Rd
Fort Wayne, IN 46815
Phone (260) 435-7001

702 Van Buren St
Fort Wayne, IN 46802
Phone (260) 425-3000

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

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": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1851973820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-790-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-790-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "COLE",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-28",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01093770A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "330640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0060457",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.