Individual provider Active NPI

Michael Shay Cole, DDS

  • Dentist
  • New Braunfels, TX
National Provider Identifier
1871602649
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D20481 Issued in TX
Practice address
1583 Common Street
Suite 202
New Braunfels, TX 78130
Phone
(830) 629-1954
Fax
(830) 625-3114
NPI assigned
Aug 29, 2006
Last updated
Oct 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D20481 TX Primary

Addresses

Primary practice location

1583 Common Street
Suite 202
New Braunfels, TX 78130

Mailing address

1583 Common Street
Suite 202
New Braunfels, TX 78130
Phone (830) 629-1954

Other identifiers 2

IdentifierTypeStateIssuer
1399228OtherTXUNITED CONCORDIA
87D656OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160623002064 TX Order and Referring Only - DentistPractitioner - Dentist 4284925173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D20481TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Todd Smith DDS PA Dentist Past Accepting new patients
Smith and Cole Dentistry PLLC Dentist Past Accepting new patients

Organizations & group practices 2

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1871602649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1583 COMMON STREET",
            "address_2": "SUITE 202",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "78130",
            "telephone_number": "830-629-1954",
            "fax_number": "830-625-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1583 COMMON STREET",
            "address_2": "SUITE 202",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "78130",
            "telephone_number": "830-629-1954",
            "fax_number": "830-625-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "MICHAEL",
        "middle_name": "SHAY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "D20481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1399228",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "87D656",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

Verify at the official NPI Registry.