Individual provider Active NPI

Collin Michael Dorner

  • Acute Care Nurse Practitioner
  • Austin, TX
National Provider Identifier
1275358350
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1186486 Issued in TX
Practice address
3705 Medical Pkwy Ste 320
Austin, TX 78705-1023
Phone
(512) 454-0392
Fax
(512) 454-1233
NPI assigned
Nov 22, 2024
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1186486 TX Primary

Addresses

Primary practice location

3705 Medical Pkwy Ste 320
Austin, TX 78705-1023

Mailing address

3705 Medical Pkwy Ste 320
Austin, TX 78705-1023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250324003804 TX Practitioner - Nurse Practitioner 4587187182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3705 Medical Pkwy
Suite 320
Austin, TX 78705-1023
Phone (512) 454-0392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Butler & Burns Ear Nose & Throat Associates CurrentSince Jan 29, 2025 Accepting new patients
Butler & Burns Ear Nose & Throat Associates CurrentSince Jan 29, 2025 Accepting new patients

Locations

3705 Medical Pkwy
Ste 320
Austin, TX 78705
Phone (512) 454-0392

6503 Menchaca Rd
Austin, TX 78745
Phone (512) 444-7944

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1275358350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY STE 320",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY STE 320",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051023",
            "telephone_number": "512-454-0392",
            "fax_number": "512-454-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNER",
        "first_name": "COLLIN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-22",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1186486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.