Active NPI
Derek Lance Collins, D.C.
- Chiropractor
- Tishomingo, OK
National Provider Identifier
1043342348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3025
- Practice address
- 109 E Main St
Tishomingo, OK 73460-2337 - Phone
- (580) 371-3330
- Fax
- (580) 371-3694
- NPI assigned
- Mar 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3025 | OK | Primary |
Addresses
Primary practice location
109 E Main St
Tishomingo, OK 73460-2337
Mailing address
PO Box 280
Tishomingo, OK 73460-0280
Phone (580) 371-3330
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043342348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 280",
"city": "TISHOMINGO",
"state": "OK",
"postal_code": "734600280",
"telephone_number": "580-371-3330",
"fax_number": "580-371-3694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 E MAIN ST",
"city": "TISHOMINGO",
"state": "OK",
"postal_code": "734602337",
"telephone_number": "580-371-3330",
"fax_number": "580-371-3694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "DEREK",
"middle_name": "LANCE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "3025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tishomingo, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.