Mark Joseph Colston, A.T.C.,

Primary specialty

SpecialistTaxonomy code 174400000X

License

36000941A Issued in IN

Practice address

1501 W Bradley Ave
Peoria, IL 61625-2417

Phone

(765) 376-2657

NPI assigned

Jan 19, 2007

Sex

Male

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

State licenses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1265585517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 HERITAGE DR",
            "city": "MACKINAW",
            "state": "IL",
            "postal_code": "617558991",
            "telephone_number": "765-376-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W BRADLEY AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616252417",
            "telephone_number": "765-376-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLSTON",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "A.T.C.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "36000941A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen A Collins, APN
• Kristina Collins, AUD
• Melanie R Collins, APN
• Christopher D Collison, MD
• Giovanni Colombo, M.D.
• Heidi Colton, LCSW
• Taylor Coltrin
• Nicholas Joseph Comardelle, MD
• Jennifer Comerford
• Comfort Plus Hospice Inc.

• Specialist in Peoria, IL
• Providers in Peoria, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.