STACEY RENE COLE (NNP) – Nurse Practitioner, NPI 1083981021
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for STACEY RENE COLE (NNP)
5200 Harry Hines Blvd
Dallas, TX 752357709
Phone: (214) 590-6571
Type: Location
1500 E Medical Center Dr
Ann Arbor, MI 481095000
Phone: (734) 936-4000
Type: Location
800 E Dawson St
Tyler, TX 757012036
Phone: (903) 606-1800
Type: Location
PO BOX 660599
DALLAS, TX 752660599
Phone:
Type: Mailing
5200 HARRY HINES BLVD
DALLAS, TX 752357709
Phone: (214) 590-6571
Type: Location
1512 W KIRBY PL
SHREVEPORT, LA 711033822
Phone: (318) 626-0287
Type: Mailing
1541 KINGS HWY
SHREVEPORT, LA 711034228
Phone: (318) 626-0000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $67.
Total Amount is formed as General ($67) + Research ($0) + Ownership ($0) = $67.
Last reported payment date: 2023-09-26 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($67).
Total Amount
$67
General + Research + Ownership
Payments
2
Total payment records
General Amount
$67
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $67 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-06-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160323000234 | I | Nurse Practitioner | TX | TBD |
| I20200603000897 | I | Nurse Practitioner | LA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75235)
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Reviews
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