Organization Active NPI

Darryl Dewitt Collins, M.D.,P.a.

  • Family Medicine Physician
  • Portland, TX
National Provider Identifier
1104074137
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DARRYL DEWITT COLLINS, M.D.,P.A.
Practice address
213 Cedar Dr
Suite a
Portland, TX 78374-2921
Phone
(361) 777-2886
Fax
(361) 777-3667
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
Dr. Darryl Dewitt Collins, M.D.NPI 1720107493
Title
Owner/Physician
Phone
(361) 777-2886

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

213 Cedar Dr
Suite a
Portland, TX 78374-2921

Mailing address

213 Cedar Dr
Suite a
Portland, TX 78374-2921
Phone (361) 777-2886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111228000455 TX Part B Supplier - Clinic/Group Practice 7012183890 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, TX

National Provider Directory

National Provider Directory

Locations

213 Cedar Dr
Ste A
Portland, TX 78374
Phone (361) 777-2886

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1104074137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 CEDAR DR",
            "address_2": "SUITE A",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783742921",
            "telephone_number": "361-777-2886",
            "fax_number": "361-777-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 CEDAR DR",
            "address_2": "SUITE A",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783742921",
            "telephone_number": "361-777-2886",
            "fax_number": "361-777-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARRYL DEWITT COLLINS, M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_middle_name": "DEWITT",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "361-777-2886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.