Jodi L McCollum, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003915 Issued in MI

Practice address

420 W Magnetic St
Suite ER
Marquette, MI 49855-2711

Phone

(906) 225-4854

Fax

(906) 225-3370

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Upper Michigan Cardiovascular Associates, PC

  • Cardiovascular Disease Physician
  • Marquette, MI
  • NPI 1649214099
  NPD
• Constance G. Arnold, M.D.,P.C.

  • Plastic Surgery Physician
  • Marquette, MI
  • NPI 1083723589
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1013067602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W MAGNETIC ST",
            "address_2": "SUITE ER",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552711",
            "telephone_number": "906-225-4854",
            "fax_number": "906-225-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MAGNETIC ST",
            "address_2": "SUITE ER",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552711",
            "telephone_number": "906-225-4854",
            "fax_number": "906-225-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "JODI",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "5601003915",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederick M Maynard Jr., M.D.
• Reata F Mayo, CRNA
• Mary McCarthy
• Patience K McCarthy, RN
• Trista McClelland, MA LPC NCC
• Julie A McDonald, PA-C
• Anna Patrice McDonnell
• Mark McGovern, DDS
• Gabrielle McGrath
• Malorie McGraw, CCC-SLP

• Physician Assistant in Marquette, MI
• Providers in Marquette, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.