Active NPI
Kyla Marie Collins, NP
- Nurse Practitioner
- Southbridge, MA
National Provider Identifier
1235960683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN2313655
- Practice address
- 222 Main St
Southbridge, MA 01550-2593 - Phone
- (508) 765-7711
- NPI assigned
- Aug 8, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN2313655 | MA | Primary |
Addresses
Primary practice location
222 Main St
Southbridge, MA 01550-2593
Mailing address
54 Alan Ave
Pascoag, RI 02859-2800
Phone (508) 579-0117
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI, MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
222 Main St
Southbridge, MA 01550-2593
Phone (508) 765-7711
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2313655 | MA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Mass Dermatology PC | Current | Accepting new patients |
Locations
222 Main St
Southbridge, MA 01550
Phone (508) 764-2758
Organizations & group practices 1
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.
-
- Procedural Dermatology Physician
- Southbridge, MA
- NPI 1730339284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723075200000",
"number": "1235960683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 ALAN AVE",
"city": "PASCOAG",
"state": "RI",
"postal_code": "028592800",
"telephone_number": "508-579-0117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 MAIN ST",
"city": "SOUTHBRIDGE",
"state": "MA",
"postal_code": "015502593",
"telephone_number": "508-765-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "KYLA",
"middle_name": "MARIE",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-08",
"last_updated": "2024-08-08",
"certification_date": "2024-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "RN2313655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southbridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.