NPIMap

Individual provider Active NPI

Kevin B Collins, MD

  • Radiation Oncology Physician
  • Union City, TN
National Provider Identifier
1174611511
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
E-0729 Issued in AR
Practice address
1109 E Reelfoot Ave Ste F
Union City, TN 38261-5867
Phone
(731) 884-1412
Fax
(731) 884-1720
NPI assigned
Oct 11, 2006
Last updated
Jun 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 8183 ND
Radiation Oncology Physician 2085R0001X 27989 MS
Radiation Oncology Physician 2085R0001X 57553 TN
Radiation Oncology Physician 2085R0001X 111463 MO
Radiation Oncology Physician 2085R0001X E-0729 AR Primary

Addresses

Primary practice location

1109 E Reelfoot Ave Ste F
Union City, TN 38261-5867

Mailing address

PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 936-7000

Other practice location 1

504 Azalea Dr Ste A
Oxford, MS 38655-5397
Phone (662) 236-7738

Other identifiers 1

IdentifierTypeStateIssuer
10859MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TN, MS3 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
I20140313000976 AR Practitioner - Radiation OncologyPractitioner - Hospice/Palliative Care 2062567175 Reassigns benefits to 2 organizations
I20180710003327 TN Practitioner - Radiation Oncology 2062567175 Reassigns benefits to 1 organization
I20200924003245 MS Practitioner - Radiation Oncology 2062567175 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation OncologyAlso: Hospice/Palliative Care
Education
University of Oklahoma College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4808 E Johnson Ave
Jonesboro, AR 72405-8413
Phone (870) 936-8000

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-3882

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.65 of 100Reported as group
Quality
44.87
Promoting interoperability
100
Improvement activities
40
Cost
73.98

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
111463MOMDRadiation Oncology Physician
57553TNMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Hospital North Mississippi, Inc CurrentSince Aug 5, 2020 Accepting new patients
Baptist Memorial Medical Group Inc Radiation Oncology CurrentSince Jun 1, 2018 Accepting new patients
Baptist Memorial Hospital North Mississippi, Inc CurrentSince Aug 5, 2020 Accepting new patients
Baptist Memorial Hospital - Golden Triangle Inc. CurrentSince Aug 5, 2020 Accepting new patients
Baptist Memorial Hospital - Golden Triangle Inc. CurrentSince Aug 5, 2020 Accepting new patients
Baptist Memorial Hospital Union County, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Current Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Jun 1, 2018 Accepting new patients
Baptist Memorial Health Services, Inc. of Mississippi Past Accepting new patients
Baptist Memorial Hospital- Union City Inc Past Accepting new patients
Baptist Memorial Hospital North Mississippi, Inc Past Accepting new patients
Trinity Hospitals PastSince Jul 1, 2008 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Past Accepting new patients
Baptist Memorial Hospital Union County, Inc. Past Accepting new patients

Locations

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

4808 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 936-7000

2520 5th St N
Columbus, MS 39705
Phone (662) 224-1000

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

200 State Highway 30 W
New Albany, MS 38652
Phone (601) 534-7631

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

2301 S Lamar Blvd
Oxford, MS 38655
Phone (662) 232-8369

504 Azalea Dr
Ste A
Oxford, MS 38655
Phone (662) 236-7738

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

2996 Kate Bond Rd
Ste 100
Bartlett, TN 38133
Phone (901) 383-5570

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

1109 E Reelfoot Ave
Ste F
Union City, TN 38261
Phone (731) 884-1412

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Interoperability endpoints

  • Direct secure messaging: kcollins29439@direct.bmhcc.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nea Baptist Memorial HospitalJonesboro, AR, CCN 040118 Hospital Corporate Director Nov 9, 2020
Nea Baptist Memorial HospitalJonesboro, AR, CCN 04T118 Hospital Corporate Officer
Corporate Director		 Nov 9, 2020
Nov 9, 2020
Elite HospiceJonesboro, AR, CCN 041521 Hospice W-2 Managing Employee Mar 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1174611511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1960",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031960",
            "telephone_number": "870-936-7000",
            "fax_number": "870-934-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 E REELFOOT AVE STE F",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615867",
            "telephone_number": "731-884-1412",
            "fax_number": "731-884-1720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "504 Azalea Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386555397",
            "country_code": "US",
            "telephone_number": "662-236-7738",
            "fax_number": "662-236-9642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KEVIN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "ND",
            "license": "8183",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MS",
            "license": "27989",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TN",
            "license": "57553",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "111463",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "AR",
            "license": "E-0729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10859",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.