Jack Lovell Collins, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G33014 Issued in CA

Practice address

1320 Celeste Dr
Modesto, CA 95355-2402

Phone

(209) 527-6900

Fax

(209) 524-7328

NPI assigned

Mar 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

University of Kansas School of Med (KC/Wich/Sal), 1974

Medicare assignment

May accept Medicare assignment

Group practices

Family Health Care Medical Group of Modesto a Professional CorpGroup PAC ID 8729025879, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JGEHCD

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.

• Family Health Care Medical Group of Modesto a Professional Corp

  • Family Medicine Physician
  • Modesto, CA
  • NPI 1912967787
  Medicare reassignment Care Compare group NPD
• Sutter Valley Hospitals

  dba Memorial Medical Center

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1699129601
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1245290865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 CELESTE DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552402",
            "telephone_number": "209-527-6900",
            "fax_number": "209-524-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 CELESTE DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552402",
            "telephone_number": "209-527-6900",
            "fax_number": "209-524-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JACK",
        "middle_name": "LOVELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G33014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaimme Coleman
• Paul B Coleman, DO
• Sineathia Coleman
• Taylor Sadielynn Coleman
• Brittany N Collins
• Julie Denise Collins, LPT
• Kathlynn L. Collins, FNP/MSN
• Leroy Collins
• Malinda Anne Collins, M.A.
• Michael Patrick Collins

• Family Medicine Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.