Individual provider Active NPI

Colleen Haley, ARNP

  • Family Nurse Practitioner
  • Jupiter, FL
National Provider Identifier
1275816266
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3025072 Issued in FL
Practice address
210 Jupiter Lakes Blvd
#4105
Jupiter, FL 33458-7191
Phone
(561) 743-9077
NPI assigned
Sep 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3025072 FL Primary

Addresses

Primary practice location

210 Jupiter Lakes Blvd
#4105
Jupiter, FL 33458-7191

Mailing address

210 Jupiter Lakes Blvd
#4105
Jupiter, FL 33458-7191
Phone (561) 743-9077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120426000452 FL Practitioner - Nurse Practitioner 0547422131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inphynet Contracting Services LLCGroup PAC ID 7416865811, 169 clinicians

Practice addresses (Care Compare)

3360 Burns Rd
Palm Beach Gardens, FL 33410-4323
Phone (561) 622-1411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3025072FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inphynet Contracting Services LLC CurrentSince Apr 1, 2018 Accepting new patients
Paragon Contracting Services LLC CurrentSince Apr 1, 2022 Accepting new patients

Locations

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1275816266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 JUPITER LAKES BLVD",
            "address_2": "#4105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587191",
            "telephone_number": "561-743-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 JUPITER LAKES BLVD",
            "address_2": "#4105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587191",
            "telephone_number": "561-743-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "COLLEEN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3025072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.