Collaborative Medical Provider Group, PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP2311 Issued in AZ

Legal business name

COLLABORATIVE MEDICAL PROVIDER GROUP, PLLC

Practice address

8300 N Westcliff Dr
Tucson, AZ 85743-1043

Phone

(602) 867-1302

Fax

(602) 867-4247

NPI assigned

Feb 24, 2016

Organization subpart

No

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

Authorized official

Name

Jody Agins, NP

Title

Sole Member

Phone

(602) 867-1302

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1245690809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 N WESTCLIFF DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857431043",
            "telephone_number": "602-867-1302",
            "fax_number": "602-867-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 N WESTCLIFF DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857431043",
            "telephone_number": "602-867-1302",
            "fax_number": "602-867-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE MEDICAL PROVIDER GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "AGINS",
        "authorized_official_first_name": "JODY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "602-867-1302",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP2311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas John Coles, DDS
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• Celyness Colina Pratts
• Collaborative Associates in Surgical Assisting
• Mason Collett
• Rachael Colley, PMHNP
• Barbara Collier
• Deanna Collier, NP
• Kathleen Lyn Collier, PHARMD

• Family Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.