Colleen E Prince, RD, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-03826 Issued in NC

Practice address

3326 Durham Chapel Hill Blvd Ste 110B
Durham, NC 27707-6241

Phone

(984) 219-1562

Fax

(984) 219-2366

NPI assigned

May 28, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2022 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Raleigh Durham Medical Group PA

  • Family Medicine Physician
  • Cary, NC
  • NPI 1295784874
  NPD (past)

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703980800000",
    "number": "1013142405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 DURHAM CHAPEL HILL BLVD STE 110B",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076241",
            "telephone_number": "984-219-1562",
            "fax_number": "984-219-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3326 DURHAM CHAPEL HILL BLVD STE 110B",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076241",
            "telephone_number": "984-219-1562",
            "fax_number": "984-219-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "COLLEEN",
        "middle_name": "E",
        "credential": "RD, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2023-12-31",
        "certification_date": "2023-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L003778",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "60078721",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03826",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-03826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primahealth Ipa LLC
• Prime Care Support Services PLLC
• Prime Care Support Services, PLLC
• Primo Transportation Services LLC
• Mariah Prince-Allen, FNP-BC
• Katherine Elizabeth Prince, FNP-C
• Princess Pines Family Care Home Inc
• Brad Prinzhorn
• Elizabeth Pritchard, LCSWA
• Nichole T Pritchard, COTA

• Medical Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.