Jason Scott Collin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

27310 Issued in CA

Practice address

2050 Dunlap Dr
South Lake Tahoe, CA 96150-6448

Phone

(530) 208-9910

Fax

(530) 285-2001

NPI assigned

Mar 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PT Revolution Physical Therapy PCGroup PAC ID 5092174987, 12 clinicians

Practice addresses (Care Compare)

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.

• PT Revolution Physical Therapy, PC

  • Physical Therapy Clinic/Center
  • South Lake Tahoe, CA
  • NPI 1467179663

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1366403933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 DUNLAP DR",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506448",
            "telephone_number": "530-208-9910",
            "fax_number": "530-285-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 DUNLAP DR",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506448",
            "telephone_number": "530-208-9910",
            "fax_number": "530-285-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Highway 50 Fl 2",
            "address_purpose": "LOCATION",
            "city": "Stateline",
            "state": "NV",
            "postal_code": "894499816",
            "country_code": "US",
            "telephone_number": "775-589-8953",
            "fax_number": "775-589-8920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1139 3rd St",
            "address_purpose": "LOCATION",
            "city": "South Lake Tahoe",
            "state": "CA",
            "postal_code": "961503465",
            "country_code": "US",
            "telephone_number": "530-543-5706",
            "fax_number": "530-541-4130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLIN",
        "first_name": "JASON",
        "middle_name": "SCOTT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2315",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "27310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carissa Clayton, PHARMD
• Nicole S Cleaves, RNFA
• Abby Cohen, MD
• Harvey Jay Cohen, D.C.
• Amanda Marie Coleman
• Natalie Evelyn Collin
• Lisa Collins, PT
• Sebastian Combes, PTA
• Molly Rom Comunale
• Mindy Ellen Cooper-Smith, M.D.

• Physical Therapist in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.