Individual provider Active NPI

John A Collins, M.D.

  • Surgery Physician
  • Fort Collins, CO
National Provider Identifier
1033178967
Registry record updated Mar 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
20419 Issued in CO
Practice address
2121 E Harmony Rd
Ste 330
Fort Collins, CO 80528-3400
Phone
(970) 221-5878
Fax
(970) 221-3564
NPI assigned
Mar 20, 2006
Last updated
Mar 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 20419 CO Primary

Addresses

Primary practice location

2121 E Harmony Rd
Ste 330
Fort Collins, CO 80528-3400

Mailing address

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538-8702
Phone (970) 221-5878

Other identifiers 3

IdentifierTypeStateIssuer
01204197MedicaidCO
P00970423OtherCOMEDICARE RAILROAD
133398400MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20419COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Specialists Surgery Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458432000000",
    "number": "1033178967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "address_2": "STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388702",
            "telephone_number": "970-221-5878",
            "fax_number": "970-221-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD",
            "address_2": "STE 330",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283400",
            "telephone_number": "970-221-5878",
            "fax_number": "970-221-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2016-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "20419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01204197",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00970423",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133398400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2016; 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.