Active NPI
Kimberly Ann Collard, OTR/L
- Health Educator
- Las Cruces, NM
National Provider Identifier
1376821959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 2822
- Practice address
- 100 Colosseo Cir
Las Cruces, NM 88012-9309 - Phone
- (575) 993-8092
- Fax
- (866) 528-1211
- NPI assigned
- Jul 29, 2011
- Last updated
- Jul 29, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 2822 | NM | Primary |
Addresses
Primary practice location
100 Colosseo Cir
Las Cruces, NM 88012-9309
Mailing address
100 Colosseo Cir
Las Cruces, NM 88012-9309
Phone (575) 993-8092
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2822 | Other | NM | OCCUPATIONAL THERAPY BOARD LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2822 | NM | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311897600000",
"number": "1376821959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 COLOSSEO CIR",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880129309",
"telephone_number": "575-993-8092",
"fax_number": "866-528-1211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 COLOSSEO CIR",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880129309",
"telephone_number": "575-993-8092",
"fax_number": "866-528-1211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLARD",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-29",
"last_updated": "2011-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "NM",
"license": "2822",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY BOARD LICENSE",
"identifier": "2822",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.