Individual provider Active NPI

Collins Bollozos

  • Occupational Therapist
  • Dallas, TX
National Provider Identifier
1265972764
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2016026845 Issued in MO
Practice address
12880 Hillcrest Rd Ste J102
Dallas, TX 75230-1532
Phone
(972) 387-1100
NPI assigned
Mar 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2016026845 MO Primary

Addresses

Primary practice location

12880 Hillcrest Rd Ste J102
Dallas, TX 75230-1532

Mailing address

12880 Hillcrest Rd Ste 102
Dallas, TX 75230-1501
Phone (972) 387-1100

Other practice location 1

11097 Saint Charles Rock Rd
Saint Ann, MO 63074-1509
Phone (314) 213-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2016026845MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy C. Havenor Past Accepting new patients
Pattonville School District Past Accepting new patients
Playworks Pediatric Therapy Services Inc Occupational Therapist PastSince Nov 26, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1265972764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12880 HILLCREST RD STE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301501",
            "telephone_number": "972-387-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12880 HILLCREST RD STE J102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301532",
            "telephone_number": "972-387-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11097 Saint Charles Rock Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Ann",
            "state": "MO",
            "postal_code": "630741509",
            "country_code": "US",
            "telephone_number": "314-213-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLOZOS",
        "first_name": "COLLINS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2016026845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.