Active NPI
Lady Carolina Collins, CPNP-PC
- Pediatric Nurse Practitioner
- Peachtree Corners, GA
National Provider Identifier
1063985414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN236463
- Practice address
- 3780 Holcomb Bridge Rd
Peachtree Corners, GA 30092-4855 - Phone
- (770) 263-9102
- NPI assigned
- Jan 8, 2019
- Sex
- Female
- 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 Nurse Practitioner | 363LP0200X | RN236463 | GA | Primary |
Addresses
Primary practice location
3780 Holcomb Bridge Rd
Peachtree Corners, GA 30092-4855
Mailing address
3780 Holcomb Bridge Rd
Peachtree Corners, GA 30092-4855
Phone (770) 263-9102
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN236463 | GA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dwelling Place Pediatrics LLC | Pediatrics | Current | Accepting new patients |
Interoperability endpoints
- lady.collins.1@11705.direct.athenahealth.com
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603584000000",
"number": "1063985414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3780 HOLCOMB BRIDGE RD",
"city": "PEACHTREE CORNERS",
"state": "GA",
"postal_code": "300924855",
"telephone_number": "770-263-9102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3780 HOLCOMB BRIDGE RD",
"city": "PEACHTREE CORNERS",
"state": "GA",
"postal_code": "300924855",
"telephone_number": "770-263-9102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "LADY",
"middle_name": "CAROLINA",
"credential": "CPNP-PC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-08",
"last_updated": "2020-10-25",
"certification_date": "2020-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "RN236463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peachtree Corners, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.