Active NPI
Collette G Brown, NP-C
- Adult Health Nurse Practitioner
- Bossier City, LA
National Provider Identifier
1003427899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 213785
- Practice address
- 2449 Hospital Dr Ste 400
Bossier City, LA 71111-1914 - Phone
- (318) 212-7902
- Fax
- (318) 212-7905
- NPI assigned
- Aug 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 213785 | LA | |
| Adult Health Nurse Practitioner | 363LA2200X | 213785 | LA | Primary |
Addresses
Primary practice location
2449 Hospital Dr Ste 400
Bossier City, LA 71111-1914
Mailing address
913 Lazywood LN
Shreveport, LA 71108-5911
Phone (318) 423-2538
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210419000838 | LA | Practitioner - Nurse Practitioner | 5991113680 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- WK Endocrine Specialists
Practice addresses (Care Compare)
2449 Hospital Dr
Suite 400
Bossier City, LA 71111-1914
Phone (318) 212-7902
Hospital & facility affiliations
- Willis Knighton Medical Center
- Minden Medical Center
- Northern Louisiana Medical Center
- Ut Health East Texas Carthage Hospital
- Springhill Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213785 | LA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WK Endocrine Specialists | Current | Accepting new patients | |
| Laura Kimball-Ravari MD and Willis-Knighton Medical Center | Past | Accepting new patients |
Locations
2449 Hospital Dr
Ste 400
Bossier City, LA 71111
Phone (318) 212-7902
1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946
Interoperability endpoints
- https://fhir.yourcareuniverse.net/tenant/51c6b6d1-0692-4788-ba2b-65a21c495bcb
- https://fhir-usa.unify.chbase.com/org/desoto-9dd32f5f
- cbrown16@direct.wkhs.com
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 and National Provider Directory roles.
-
- Endocrinology, Diabetes & Metabolism Physician
- Bossier City, LA
- NPI 1073831004
LA
-
- Endocrinology, Diabetes & Metabolism Physician
- Bossier City, LA
- NPI 1780610824
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Springhill, LA
- NPI 1275506115
Hospital
-
- General Acute Care Hospital
- Bossier City, LA
- NPI 1003968579
Hospital
-
- General Acute Care Hospital
- Shreveport, LA
- NPI 1124170691
Hospital
-
- General Acute Care Hospital
- Shreveport, LA
- NPI 1275685539
Hospital
-
- General Acute Care Hospital
- Shreveport, LA
- NPI 1568461572
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597363200000",
"number": "1003427899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "913 LAZYWOOD LN",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711085911",
"telephone_number": "318-423-2538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2449 HOSPITAL DR STE 400",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711111914",
"telephone_number": "318-212-7902",
"fax_number": "318-212-7905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "COLLETTE",
"middle_name": "G",
"name_prefix": "Mrs.",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-14",
"last_updated": "2020-08-14",
"certification_date": "2020-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "LA",
"license": "213785",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "LA",
"license": "213785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bossier City, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.