Active NPI
Jonathan C Collins, M.D.
- Pediatric Adolescent Medicine Physician
- Aiken, SC
National Provider Identifier
1053383000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 11083
- Practice address
- 206 Centre South Blvd
Aiken, SC 29803-6319 - Phone
- (803) 642-9204
- Fax
- (803) 648-3633
- NPI assigned
- Feb 3, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 11083 | SC | Primary |
Addresses
Primary practice location
206 Centre South Blvd
Aiken, SC 29803-6319
Mailing address
30 Cherry Hills Dr
Aiken, SC 29803-5691
Phone (803) 642-9525
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110837 | Medicaid | SC |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11083 | SC | MD | Pediatric Adolescent Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1053383000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 CHERRY HILLS DR",
"city": "AIKEN",
"state": "SC",
"postal_code": "298035691",
"telephone_number": "803-642-9525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 CENTRE SOUTH BLVD",
"city": "AIKEN",
"state": "SC",
"postal_code": "298036319",
"telephone_number": "803-642-9204",
"fax_number": "803-648-3633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "JONATHAN",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "SC",
"license": "11083",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110837",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Aiken, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.