Organization Active NPI

James M. Collier III, MD, PSC

  • Family Medicine Physician
  • Lexington, KY
National Provider Identifier
1306897012
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20763 Issued in KY
Legal business name
JAMES M. COLLIER III, MD, PSC
Practice address
220 Cedar St
Ste 401
Lexington, KY 40508-2986
Phone
(859) 425-1117
Fax
(859) 425-1130
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Authorized official

Name
James M Collier III, M.D.NPI 1942252606
Title
Medical Doctor
Phone
(859) 425-1117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 20763 KY Primary

Addresses

Primary practice location

220 Cedar St
Ste 401
Lexington, KY 40508-2986

Mailing address

169 Burt Rd
Lexington, KY 40503-2455
Phone (859) 278-9242

Other identifiers 2

IdentifierTypeStateIssuer
7100079930MedicaidKY
DC1667OtherKYRAILRAID MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000543 KY Part B Supplier - Clinic/Group Practice 3173418639 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory

Locations

135 E Maxwell St
Ste 303
Lexington, KY 40508
Phone (859) 255-5053

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1306897012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 BURT RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032455",
            "telephone_number": "859-278-9242",
            "fax_number": "859-278-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CEDAR ST",
            "address_2": "STE 401",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405082986",
            "telephone_number": "859-425-1117",
            "fax_number": "859-425-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES M. COLLIER III, MD, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "859-425-1117",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "20763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100079930",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAID MEDICARE",
            "identifier": "DC1667",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.