Macy Michelle Collins

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209030396 Issued in IL

Practice address

200 S Cedar St
Shelbyville, IL 62565-1838

Phone

(217) 774-4400

Fax

(217) 774-6445

NPI assigned

Sep 1, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Macy Michelle Golladay Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, MN, ND, AK, TX5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 5

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

HSHS Good Shepherd Hospital IncGroup PAC ID 9335031061, shared by 3 NPIs, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• HSHS Good Shepherd Hospital Inc

  • Critical Access Hospital
  • Shelbyville, IL
  • NPI 1053348532
  Medicare reassignment NPD
• HSHS Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1962644807
  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1154358232
  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1225101041
  Medicare reassignment NPD
• Yukon-Kuskokwim Health Corporation

  • Physician Assistant
  • Bethel, AK
  • NPI 1447477815

  TX

  Medicare reassignment
• HSHS Good Shepherd Hospital Inc

  • Rural Health Clinic/Center
  • Shelbyville, IL
  • NPI 1750350922
  NPD
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Dieterich, IL
  • NPI 1033841192
  NPD
• SJL Health Systems Inc

  • Skilled Nursing Facility
  • Pana, IL
  • NPI 1215037353
  NPD
• Norton Sound Health Corporation

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nome, AK
  • NPI 1427187046
  NPD
• Peterson Medical Clinics, LLC

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1699295774
  NPD

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1215713631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SOUTH CEDAR STREET",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "62565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S CEDAR ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625651838",
            "telephone_number": "217-774-4400",
            "fax_number": "217-774-6445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "226 Pleasant Way",
            "address_purpose": "LOCATION",
            "city": "Jesup",
            "state": "GA",
            "postal_code": "315458521",
            "country_code": "US",
            "telephone_number": "912-777-2971",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "755 S Main St",
            "address_purpose": "LOCATION",
            "city": "Baxley",
            "state": "GA",
            "postal_code": "315130130",
            "country_code": "US",
            "telephone_number": "912-367-4614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1240 S 1st St",
            "address_purpose": "LOCATION",
            "city": "Jesup",
            "state": "GA",
            "postal_code": "315457700",
            "country_code": "US",
            "telephone_number": "912-427-9338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MACY",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-01",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN286821",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209030396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcollins458160@ewd.direct.hshs.org",
            "affiliation": "N",
            "address_1": "200 S Cedar St",
            "city": "Shelbyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625651838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MACY",
            "last_name": "GOLLADAY",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cep America-Illinois Hospitalists, LLP
• Cepamerica Illinois LLP
• Craig B Chaney, MD
• Amy Jo Clarey
• Jacqueline R Clayton, APN
• Community Care Systems, Inc.
• County of Shelby
• Tammy Michelle Craig
• Daisy Ann Cravens, MS
• Kayci Creviston

• Psychiatric/Mental Health Nurse Practitioner in Shelbyville, IL
• Providers in Shelbyville, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.