Individual provider Active NPI

Ben Arnold Collins Jr., D.O.

  • Geriatric Medicine (Internal Medicine) Physician
  • Ankeny, IA
National Provider Identifier
1225030836
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
02679 Issued in IA
Practice address
1325 NE 31St St
Ankeny, IA 50021-6695
Phone
(515) 279-1959
Fax
(515) 289-0888
NPI assigned
Aug 12, 2005
Last updated
May 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 02679 IA Primary

Addresses

Primary practice location

1325 NE 31St St
Ankeny, IA 50021-6695

Mailing address

2213 Grand Ave
Des Moines, IA 50312-5305
Phone (515) 237-3974

Other identifiers 3

IdentifierTypeStateIssuer
110165879OtherIARR MEDICARE
1457304446OtherIAWELLMARK BCBS
0255620MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090513000204 IA Practitioner - General PracticePractitioner - Internal MedicinePractitioner - Osteopathic Manipulative MedicinePractitioner - Pediatric MedicinePractitioner - Geriatric Medicine 2062304488 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02679IAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
On With Life, Inc CurrentSince Sep 1, 2019 Accepting new patients
On With Life, Inc. CurrentSince Sep 1, 2019 Accepting new patients

Locations

715 SW Ankeny Rd
Ankeny, IA 50023
Phone (515) 289-9600

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1225030836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125305",
            "telephone_number": "515-237-3974",
            "fax_number": "515-883-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 NE 31ST ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500216695",
            "telephone_number": "515-279-1959",
            "fax_number": "515-289-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "BEN",
        "middle_name": "ARNOLD",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IA",
            "license": "02679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110165879",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "1457304446",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0255620",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

Verify at the official NPI Registry.