Dr Jackie L McCollum, MD. P.C.

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

28393 Issued in CO

Legal business name

DR JACKIE L MCCOLLUM, MD. P.C.

Practice address

12101 E 2ND Ave
Suite 105
Aurora, CO 80011-8327

Phone

(720) 535-6204

Fax

(720) 949-0540

NPI assigned

Dec 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jackie Lynne McCollum, MDNPI 1316966674

Title

President

Phone

(720) 535-6204

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jackie Lynne McCollum, M.D.

  • Family Medicine Physician
  • Aurora, CO
  • NPI 1316966674
  NPD Authorized official
• Linh Nguyen, MD

  • Family Medicine Physician
  • Aurora, CO
  • NPI 1952807943
  NPD

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1174706808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 E 2ND AVE",
            "address_2": "SUITE 105",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800118327",
            "telephone_number": "720-535-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 E 2ND AVE",
            "address_2": "SUITE 105",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800118327",
            "telephone_number": "720-535-6204",
            "fax_number": "720-949-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JACKIE L MCCOLLUM, MD. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "MCCOLLUM",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "720-535-6204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CO",
            "license": "28393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret F Dozier, MD
• DP Assisting
• DP Assisting
• DP Assisting
• Dr J Chiropractic LLC
• Dr Jay Dworkin PC
• Dr Jennie Brown DDS PC
• Dr Kevin Anderson & Associates, PC.
• Dr Kylie Castans Optometry LLC
• Dr Robert Andrus DDS

• Point of Service in Aurora, CO
• Providers in Aurora, CO by specialty
• Point of Service in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.