NPIMap

Individual provider Active NPI

Gabriel Lee Collins, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Cookeville, TN
National Provider Identifier
1104315282
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
5152 Issued in TN
Practice address
115 N Peachtree Ave
Cookeville, TN 38501-2546
Phone
(931) 528-2836
NPI assigned
May 4, 2018
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 5152 TN Primary

Addresses

Primary practice location

115 N Peachtree Ave
Cookeville, TN 38501-2546

Mailing address

115 N Peachtree Ave
Cookeville, TN 38501-2546
Phone (931) 528-2836

Other practice location 1

1924 Alcoa Hwy
Knoxville, TN 37920-1511
Phone (865) 305-8994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AL, FL3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20250219000680 TN Practitioner - PathologyPractitioner - Hematology 0143740399 Reassigns benefits to 1 organization
I20250617004263 AL Practitioner - Pathology 0143740399
I20251009002731 FL Practitioner - Pathology 0143740399

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Hematology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Pathology Laboratory LLCGroup PAC ID 7416860242, 4 clinicians

Practice addresses (Care Compare)

115 N Peachtree Ave
Cookeville, TN 38501-2546
Phone (931) 528-2836

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2726ALMDProfessional Counselor
5152TNMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DW McMillan Memorial Hospital Current Accepting new patients
DW McMillan Memorial Hospital Current Accepting new patients
Community Pathology Laboratory LLC CurrentSince Jan 1, 2025 Accepting new patients
Vivid Pathology PA Anatomic Pathology & Clinical Pathology CurrentSince Oct 2, 2025 Accepting new patients

Locations

1301 Belleville Ave
Brewton, AL 36426
Phone (251) 809-8439

4900 Bayou Blvd
Ste 204
Pensacola, FL 32503
Phone (843) 518-2854

5700 Southwyck Blvd
Toledo, OH 43614

115 N Peachtree Ave
Cookeville, TN 38501
Phone (931) 528-2836

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1104315282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N PEACHTREE AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012546",
            "telephone_number": "931-528-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N PEACHTREE AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012546",
            "telephone_number": "931-528-2836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1924 Alcoa Hwy",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379201511",
            "country_code": "US",
            "telephone_number": "865-305-8994",
            "fax_number": "865-305-6866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "GABRIEL",
        "middle_name": "LEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-04",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "5152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.