Teresia McCollister

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

RN 268022 Issued in CA

Practice address

2411 N Broadway
Los Angeles, CA 90031-2218

Phone

(323) 987-2000

Fax

(323) 987-1448

NPI assigned

Aug 26, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Arroyo Vista Family Health Foundation

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1447353701
  Medicare reassignment NPD
• Arroyo Vista Family Health Foundation

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1891837621
  NPD

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1336132166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 N FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900424232",
            "telephone_number": "323-254-5221",
            "fax_number": "323-254-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312218",
            "telephone_number": "323-987-2000",
            "fax_number": "323-987-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLISTER",
        "first_name": "TERESIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "RN 268022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tahirah McCloyn, MSW
• Amy Catherine McClune, M.D.
• Alexandra McClung, LCSW
• Sharon McCohn
• Reevia Jean McCollins
• Fairlie McCollough, ACSW
• Jane Tyresha McCollul
• James Gordon McComb, MD
• Jeffrey Scott McCombs, DC
• Claudia McConico

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.