Kristen Collister, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

34604 Issued in OK

Practice address

608 Stanton L Young Blvd # 509
Oklahoma City, OK 73104-5014

Phone

(405) 271-7816

NPI assigned

Jun 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristen Russell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: kcollister60581@ouhealth.direct-ci.net

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

{
    "created_epoch": "1530316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1255826376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 STANTON L YOUNG BLVD # 509",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045014",
            "telephone_number": "405-271-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 STANTON L YOUNG BLVD # 509",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045014",
            "telephone_number": "405-271-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLISTER",
        "first_name": "KRISTEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-30",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "TEP8298",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "34604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "RUSSELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Collins, DDS
• Shaleitha Collins
• Sondra Haley Collins
• Susanne Michele Collins
• Teena Gaye Collins, M.S.,L.P.C.,N.C.C
• Peter Collister, MD
• Debra Ann Colombe, R.D.
• Colon and Rectal Surgery of Oklahoma, P.C.
• Visani Colon, MS
• Anna Canoy Colston, PA

• Ophthalmology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Ophthalmology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; 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.