Collegiate Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

COLLEGIATE MEDICAL LLC

Practice address

6721 W 128TH PL
104
Overland Park, KS 66209-3842

Phone

(913) 269-0330

Fax

(913) 273-1070

NPI assigned

May 13, 2013

Last updated

May 13, 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

Warren Peterson

Title

President

Phone

(913) 269-0330

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1184060568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9238",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662011838",
            "telephone_number": "913-269-0330",
            "fax_number": "913-273-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6721 W 128TH PL",
            "address_2": "104",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093842",
            "telephone_number": "913-269-0330",
            "fax_number": "913-273-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGIATE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-269-0330"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Julie Ann Colley
• Kristy Colley, LMT
• Sydney Elizabeth Collier, DC
• Tracey R Collier, OT
• Amy E Collins, APRN

• Durable Medical Equipment & Medical Supplies in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Durable Medical Equipment & Medical Supplies in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.