Individual provider Active NPI

Coretta H. Collins, CRNP

  • Acute Care Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1104258532
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-121710 Issued in AL
Practice address
619 19TH St S
Birmingham, AL 35249-6806
Phone
(205) 934-4011
Fax
(205) 502-5183
NPI assigned
Aug 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-121710 AL
Acute Care Nurse Practitioner 363LA2100X 1-121710 AL Primary

Addresses

Primary practice location

619 19TH St S
Birmingham, AL 35249-6806

Mailing address

PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20140910001340 AL Practitioner - Nurse Practitioner 6305065160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hematology and Oncology Associates of Alabama, LLC Current Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Jun 1, 2022 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

2000 6th Ave S
Birmingham, AL 35233
Phone (205) 731-9396

1201 11th Ave S
Birmingham, AL 35205
Phone (205) 930-7100

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

339 Walker Chapel Plz
Ste 109
Fultondale, AL 35068
Phone (205) 380-7878

513 Brookwood Blvd
Ste 275
Homewood, AL 35209
Phone (205) 502-4700

209 W Spring St
Ste 303
Sylacauga, AL 35150
Phone (256) 249-0943

Interoperability endpoints

  • Direct secure messaging: corettacollins@direct.uabmedicine.org

Organizations & group practices 2

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 2

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": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1104258532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310",
            "telephone_number": "205-731-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352496806",
            "telephone_number": "205-934-4011",
            "fax_number": "205-502-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "CORETTA",
        "middle_name": "H.",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-121710",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-121710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.