Jack Martin Cole, MD
Individual provider Active NPI Internal Medicine Physician · Landrum, SC
NPI 1922051150 · NPPES record last updated May 7, 2021
Key facts
- NPI
- 1922051150
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 15903 (SC)
- Practice address
- 133 N Howard Ave
Landrum, SC 29356-1507 - Phone
- (864) 457-3838
- Fax
- (864) 560-9532
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of North Carolina at Chapel Hill School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Proactive Therapy of North Carolina Inc
Practice addresses (Care Compare)
2303 Wellington Dr SW
Suite B
Wilson, NC 27893-8620
Phone (252) 243-6818
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070319000113 | SC | Practitioner - Internal Medicine | 7416050182 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherokee Medical Center | Current |
Accepting new patients | |
| Cherokee Medical Center | Current |
Accepting new patients | |
| Spartanburg Hospital for Restorative Care | Past | Accepting new patients |
Locations
840 W Floyd Baker Blvd
Gaffney, SC 29341
Phone (864) 489-3300
101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 15903 | SC | Yes |
Addresses
Primary practice location
133 N Howard Ave
Landrum, SC 29356-1507
Mailing address
PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SCJ0086633 | Other | SC | MEDICARE PIN |
| SCJ0086084 | Other | SC | MEDICARE PIN |
| SCJ008J577 | Other | SC | MEDICARE PIN |
| 159036 | Medicaid | SC | |
| P01397050 | Other | SC | RAILROAD MEDICARE |
| SCJ0085019 | Other | SC | MEDICARE PIN |
| SCJ0085121 | Other | SC | MEDICARE PIN |
| SCJ0086067 | Other | SC | MEDICARE PIN |
Other providers in Landrum, SC
- Jordan Clifford Burnett
- Joanne Louise Cahill
- Ansley Lynn Campbell
- Kathren Brooke Carlton
- Arielle Barraca Clark
- Nicolas Seth Dawson
- Leslie Desimone
- Dialysis Clinic Inc.
- Vivian Isabel Dunlop
- Fagan Chiropractic LLC
All providers in Landrum, SC · Internal Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.