Active NPI
Mercedes Collazo, RN, BSN
- Registered Nurse
- Pottsville, PA
National Provider Identifier
1114662012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN755495
- Practice address
- 1603 Mahantongo St
Pottsville, PA 17901-3222 - Phone
- (570) 516-9535
- NPI assigned
- May 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 704537 | NY | |
| Registered Nurse | 163W00000X | RN755495 | PA | Primary |
Addresses
Primary practice location
1603 Mahantongo St
Pottsville, PA 17901-3222
Mailing address
PO Box 905
Pottsville, PA 17901-0905
Phone (570) 516-9535
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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 704537 | NY | MD | Registered Nurse |
| RN755495 | PA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651881600000",
"number": "1114662012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 905",
"city": "POTTSVILLE",
"state": "PA",
"postal_code": "179010905",
"telephone_number": "570-516-9535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1603 MAHANTONGO ST",
"city": "POTTSVILLE",
"state": "PA",
"postal_code": "179013222",
"telephone_number": "570-516-9535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLAZO",
"first_name": "MERCEDES",
"name_prefix": "Mrs.",
"credential": "RN, BSN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-04",
"last_updated": "2022-05-07",
"certification_date": "2022-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "704537",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN755495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pottsville, PA
- Clinical Outcomes Group, Inc.
- Clinical Social Worker Associates, Inc.
- Cole Vision Corporation
- Cristin Ashley Cole, MA
- Michelle Coleman, LCSW
- Comprehensive Physiatry LLC
- Comprehensive Women'S Health Services, P.C.
- Comprehensive Women'S Health Services, P.C.
- Jillian Marie Compton
- William S Connolly, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.