Collinwood Family Care, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

COLLINWOOD FAMILY CARE, LLC

Practice address

105 3Rd Ave N
Collinwood, TN 38450-4696

Phone

(931) 724-4628

Fax

(931) 724-4705

NPI assigned

Jul 15, 2020

Organization subpart

No

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

Authorized official

Name

Daysha A Brantley, APNNPI 1609978048

Title

Nurse Practitioner / Owner

Phone

(931) 724-4628

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daysha A Brantley, MSN, FNP-C

  • Family Nurse Practitioner
  • Collinwood, TN
  • NPI 1609978048

  Family, TN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1023626124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 3RD AVE N",
            "city": "COLLINWOOD",
            "state": "TN",
            "postal_code": "384504696",
            "telephone_number": "931-724-4628",
            "fax_number": "931-724-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 3RD AVE N",
            "city": "COLLINWOOD",
            "state": "TN",
            "postal_code": "384504696",
            "telephone_number": "931-724-4628",
            "fax_number": "931-724-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLINWOOD FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-15",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "DAYSHA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "NURSE PRACTITIONER / OWNER",
        "authorized_official_telephone_number": "931-724-4628",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q004852",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q060911",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daysha A Brantley, MSN, FNP-C
• Jacqualyn Brittney Brison
• Carla Staggs
• Carla Staggs
• Collinwood Drugs
• David M. Magas, M.D.
• Fast Pace Medical Clinic PLLC
• Leigh Abbie Hammond, LCSW
• Hollis Home Care, Incorporated
• Heather Bryan Johnston

• All providers in Collinwood, TN
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.