Collaborative Healthcare LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

COLLABORATIVE HEALTHCARE LLC

Practice address

716 Old Cherokee Rd
Lexington, SC 29072-9406

Phone

(803) 359-2273

Fax

(803) 359-3497

NPI assigned

Jun 5, 2013

Last updated

Jun 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shane Conner, DC

Title

President

Phone

(803) 359-2273

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Darin Shane Conner, D.C.

  • Chiropractor
  • Lexington, SC
  • NPI 1952324501
  Medicare reassignment Care Compare group NPD
• Sonya Lane, PT

  • Physical Therapist
  • Lexington, SC
  • NPI 1598058315
  Medicare reassignment Care Compare group NPD
• Elizabeth Baker Tumaliuan, ACNP

  • Acute Care Nurse Practitioner
  • Columbia, SC
  • NPI 1275016586
  Medicare reassignment Care Compare group NPD
• Amit Singh, D.O.

  • Anesthesiology Physician
  • Madison, WI
  • NPI 1235392127
  NPD (past)

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1174961882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 OLD CHEROKEE RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729406",
            "telephone_number": "803-359-2273",
            "fax_number": "803-359-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 OLD CHEROKEE RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729406",
            "telephone_number": "803-359-2273",
            "fax_number": "803-359-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-05",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-359-2273",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cola Pediatric Therapy Collective
• Maria Colchin, RD LDN
• Heather L Coleman, LISW-CP
• Jordan Andrew Coleman, CRNA
• Thatcher Reid Coleman, LPCA
• Vanessa Collazo
• Collective Eyecare LLC (Eyes on Sunset)
• Dana Tooley Collins, OT
• Julie Livingston Collins, DC
• Brittany Nichole Collinsworth, LMSW

• Physical Medicine & Rehabilitation Physician in Lexington, SC
• Providers in Lexington, SC by specialty
• Physical Medicine & Rehabilitation Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.