NPIMap

Organization Active NPI

Marri Portia Collom FNP PLLC

  • Family Nurse Practitioner
  • Nederland, CO
National Provider Identifier
1245634997
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0990991-NP Issued in CO
Legal business name
MARRI PORTIA COLLOM FNP PLLC
Practice address
350 East St
#1307
Nederland, CO 80466-5001
Phone
(303) 775-3401
NPI assigned
Oct 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Marri Collom, APNNPI 1639404007
Title
FNP/ Practice Owner
Phone
(303) 775-3401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APN.0990991-NP CO Primary

Addresses

Primary practice location

350 East St
#1307
Nederland, CO 80466-5001

Mailing address

PO Box 1307
Nederland, CO 80466-1307
Phone (303) 775-3401

Other identifiers 1

IdentifierTypeStateIssuer
39877833MedicaidCO

Other names 1

  • Your Neighborhood Nurse Practitioner Other name

National Provider Directory

National Provider Directory

Locations

350 East St
Unit 1307
Nederland, CO 80466
Phone (303) 775-3401

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1245634997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1307",
            "city": "NEDERLAND",
            "state": "CO",
            "postal_code": "804661307",
            "telephone_number": "303-775-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 EAST ST",
            "address_2": "#1307",
            "city": "NEDERLAND",
            "state": "CO",
            "postal_code": "804665001",
            "telephone_number": "303-775-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARRI PORTIA COLLOM FNP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-09",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "COLLOM",
        "authorized_official_first_name": "MARRI",
        "authorized_official_title_or_position": "FNP/ PRACTICE OWNER",
        "authorized_official_telephone_number": "303-775-3401",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0990991-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39877833",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Your Neighborhood Nurse Practitioner",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Nederland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; 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.