Jennifer Dawn McCollum, ATC-L

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0190 Issued in NC

Practice address

110 Whitford Dr
Durham, NC 27708-9982

Phone

(919) 668-5744

NPI assigned

Mar 21, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1584748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584748800000",
    "number": "1235765207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 FORRESTDALE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277122981",
            "telephone_number": "919-812-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WHITFORD DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277089982",
            "telephone_number": "919-668-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "credential": "ATC-L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-21",
        "last_updated": "2020-03-21",
        "certification_date": "2020-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "0190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Citrix.duke.edu",
            "affiliation": "N",
            "endpointDescription": "Access to medical files through the hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Includes labs and radiology",
            "address_1": "110 Whitford Dr",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277089982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jay Donald McClennen, AOCAD
• Francis Joseph McClernon, PH.D.
• Melissa McClung
• Mary Joan McClure
• Charita Kincy McCollers, LCSW
• Kasey Jeanene McCollum, MD
• Kathryn Hardison McCollum, MS, RD, LDN
• Sally McCollum, PHARMD, CPP
• Hunter William McCombs
• Joshua M McConkey, M.D.

• Athletic Trainer in Durham, NC
• Providers in Durham, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2020; 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.