Individual provider Active NPI

Collin Marshall Brown

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1316400765
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
15821 Hollyfern CT
Fort Myers, FL 33908-3732
Phone
(239) 432-5100
NPI assigned
Apr 12, 2019
Last updated
Mar 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

15821 Hollyfern CT
Fort Myers, FL 33908-3732

Mailing address

19551 Bowring Park Rd Apt 105
Fort Myers, FL 33967-5231
Phone (765) 667-8613

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
I20210107001251 FL Practitioner - Physician Assistant 6406269695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Center of Florida, IncGroup PAC ID 9931183639, 48 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

10201 Arcos Ave
Suite 206
Estero, FL 33928-9461
Phone (239) 946-4880

12670 Creekside LN
Fort Myers, FL 33919-3370
Phone (239) 482-2663

20009 Verdana Village Blvd
Unit 103
Estero, FL 33928-9826
Phone (419) 221-6717

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Center of Florida, Inc CurrentSince Jul 1, 2025 Accepting new patients

Locations

10201 Arcos Ave
Ste 206
Estero, FL 33928
Phone (239) 482-2663

12670 Creekside Ln
Ste 202
Fort Myers, FL 33919
Phone (239) 267-2263

8350 Riverwalk Park Blvd
Ste 1
Fort Myers, FL 33919
Phone (239) 482-2663

3530 Kraft Rd
Ste 201
Naples, FL 34105
Phone (239) 445-2112

Interoperability endpoints

  • Direct secure messaging: cbrown253923@direct.leememorial.org
  • Direct secure messaging: collin.brown.1@22724.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1316400765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19551 BOWRING PARK RD APT 105",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339675231",
            "telephone_number": "765-667-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15821 HOLLYFERN CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083732",
            "telephone_number": "239-432-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "COLLIN",
        "middle_name": "MARSHALL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.