Individual provider Active NPI

Colette Dollison, APRN, NP

  • Family Nurse Practitioner
  • Blacklick, OH
National Provider Identifier
1063977122
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024089 Issued in OH
Practice address
8444 Amarillo Dr
Blacklick, OH 43004-8121
Phone
(614) 588-7421
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.024089 OH Primary

Addresses

Primary practice location

8444 Amarillo Dr
Blacklick, OH 43004-8121

Mailing address

8444 Amarillo Dr
Blacklick, OH 43004-8121
Phone (614) 588-7421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210223001984 OH Practitioner - Nurse Practitioner 3072928142 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

945 Bethesda Dr
Suite 110
Zanesville, OH 43701-1880
Phone (740) 454-5962

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Incare Health Solutions LLC CurrentSince Mar 18, 2022 Accepting new patients
Genesis Medical Group, LLC CurrentSince Mar 16, 2021 Accepting new patients
Genesis Medical Group LLC CurrentSince Mar 16, 2021 Accepting new patients
Incare Health Solutions, LLC Family CurrentSince Mar 18, 2022 Accepting new patients
Midwest Ohio Five Medical Group, PLLC Past Accepting new patients

Locations

65 N Waggoner Rd
Blacklick, OH 43004
Phone (614) 604-8805

5059 N High St
Columbus, OH 43214
Phone (614) 987-7537

211 Edgefield Blvd
Marion, OH 43302

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

2562 W Market St
Tiffin, OH 44883
Phone (567) 938-8008

945 Bethesda Dr
Ste 110
Zanesville, OH 43701
Phone (740) 450-4271

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1063977122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 AMARILLO DR",
            "city": "BLACKLICK",
            "state": "OH",
            "postal_code": "430048121",
            "telephone_number": "614-588-7421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8444 AMARILLO DR",
            "city": "BLACKLICK",
            "state": "OH",
            "postal_code": "430048121",
            "telephone_number": "614-588-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLLISON",
        "first_name": "COLETTE",
        "name_prefix": "Mrs.",
        "credential": "APRN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacklick, OH

Sources for this page

Verify at the official NPI Registry.