Tielesha M Collins

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Practice address

8808 Irish Bend Dr
Fort Worth, TX 76123-2630

Phone

(817) 905-0812

Fax

(682) 255-5429

NPI assigned

Mar 4, 2021

Last updated

Mar 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1255926937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8808 IRISH BEND DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232630",
            "telephone_number": "817-905-0812",
            "fax_number": "682-255-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8808 IRISH BEND DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232630",
            "telephone_number": "817-905-0812",
            "fax_number": "682-255-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "TIELESHA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark F. Collins, M.D.
• Meagan Collins, FNP-C
• Nnyekaa Collins, M.D.
• Shanequa Collins
• Tara Jane Collins, OTD, OTR/L
• Jessica Collup
• Krishna Prasad Colluru, DDS
• Priya Vinothini Colluru
• Isabel Angelie Colon Garcia
• Colon Me Clean (Yvonne H. Thomas)

• Adult Care Home Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Adult Care Home Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.