Individual provider Active NPI

Colleen Michelle Gonzales Tamayo

  • Student in an Organized Health Care Education/Training Program
  • Halethorpe, MD
National Provider Identifier
1104773043
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1125 Regina Dr
Halethorpe, MD 21227-2342
Phone
(443) 529-4553
NPI assigned
Mar 11, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1125 Regina Dr
Halethorpe, MD 21227-2342

Mailing address

1125 Regina Dr
Halethorpe, MD 21227-2342
Phone (443) 529-4553

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

NPI Registry JSON

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

{
    "created_epoch": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1104773043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 REGINA DR",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212272342",
            "telephone_number": "443-529-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 REGINA DR",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212272342",
            "telephone_number": "443-529-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAYO",
        "first_name": "COLLEEN MICHELLE",
        "middle_name": "GONZALES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Halethorpe, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.