Individual provider Active NPI

Stephen Edward Collier, M.D.

  • Internal Medicine Physician
  • Jackson, TN
National Provider Identifier
1316058340
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41756 Issued in TN
Practice address
29 N Star Dr
Sute C
Jackson, TN 38305-6656
Phone
(731) 664-7949
Fax
(731) 664-6141
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 41756 TN Primary

Addresses

Primary practice location

29 N Star Dr
Sute C
Jackson, TN 38305-6656

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 423-8697

Other identifiers 1

IdentifierTypeStateIssuer
3827835MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070125000195 TN Practitioner - Internal Medicine 8123078193 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

29 N Star Dr
Sute C
Jackson, TN 38305-6656

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
State of Tennessee-Western Mental Health Institute CurrentSince Mar 15, 2022 Accepting new patients
Ark Academy, LLC Current Accepting new patients
Bethesda Health Services, LLC Internal Medicine CurrentSince Jan 2, 2015 Accepting new patients
John W Scarborough MD PC Past Accepting new patients
Jackson Madison County General Hospital Past Accepting new patients
Skyline Eye Clinic, PC PastSince Jun 23, 2020 Accepting new patients
Eagles Nest of Gastonia Past Accepting new patients

Locations

11100 Highway 64
Bolivar, TN 38008
Phone (731) 228-0772

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

106 Stonebridge Blvd
Jackson, TN 38305
Phone (731) 426-3464

49 Old Hickory Blvd
Jackson, TN 38305
Phone (731) 664-4414

29 N Star Dr
Ste D
Jackson, TN 38305
Phone (731) 426-3464

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1316058340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-423-8697",
            "fax_number": "731-422-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 N STAR DR",
            "address_2": "SUTE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383056656",
            "telephone_number": "731-664-7949",
            "fax_number": "731-664-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIER",
        "first_name": "STEPHEN",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "41756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3827835",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.