Cole Evans Dickerson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5351 Issued in AR

Practice address

1415 Commerce Dr Ste a
Pocahontas, AR 72455-1495

Phone

(870) 248-0800

Fax

(870) 248-0802

NPI assigned

Jun 17, 2015

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

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Five Rivers Therapy Services Limited PartnershipGroup PAC ID 3173535036, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Five Rivers Therapy Services Limited Partnership

  • Physical Therapist
  • Pocahontas, AR
  • NPI 1801840616
  Medicare reassignment Care Compare group NPD
• Momentum Physical Rehabilitation, LLC

  • Physical Therapist
  • Memphis, TN
  • NPI 1639172653
  NPD (past)

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1881075679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 COMMERCE DR STE A",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724551495",
            "telephone_number": "870-248-0800",
            "fax_number": "870-248-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 COMMERCE DR STE A",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724551495",
            "telephone_number": "870-248-0800",
            "fax_number": "870-248-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "COLE",
        "middle_name": "EVANS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000010465",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "5351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0446657",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4004523",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashlynn McKenzi Dacus, PHARMD
• Jennifer Marie Daffron, MS, CCC-SLP
• Leah A Davis
• J Drew Dawson, MD
• Bryce Keith Decker, COTA/L
• Cindy Difani, MCD,CCC-SLP
• Rhonda Difani, RN
• Tiffany Difani, OT
• Autumn Dillon
• Diversicare Leasing Corp.

• Physical Therapist in Pocahontas, AR
• Providers in Pocahontas, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.