Jessica McCollister, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

318963 Issued in NY

Practice address

3 Willowick Dr
Fairport, NY 14450-8944

Phone

(585) 944-9570

NPI assigned

Jul 22, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1285041269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WILLOWICK DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144508944",
            "telephone_number": "585-944-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WILLOWICK DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144508944",
            "telephone_number": "585-944-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLISTER",
        "first_name": "JESSICA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "318963",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "318963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318963",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Susan Mauro, MS CCC SLP
• Bonnie D Maute, LCSW CEAP SAP
• Michael S. Mayer, D.M.D.
• Heather McAdoo
• Karen Gordon McAlpin
• Marianna Irene McCormack, M.S., O.T.R.
• Christina Marie McCormick, OTR/L
• Janice Ann McCutchan, OTRL
• Terri Ann McDonald, LPN
• Stacie McElroy

• Licensed Practical Nurse in Fairport, NY
• Providers in Fairport, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.