Active NPI
Madison Colaw
- Pediatrics Physician
- Keystone Heights, FL
National Provider Identifier
1386499770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 39087
- Practice address
- 3631 SE 2ND Ave
Keystone Heights, FL 32656-6143 - Phone
- (386) 546-1637
- NPI assigned
- Apr 19, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 39087 | FL | Primary |
Addresses
Primary practice location
3631 SE 2ND Ave
Keystone Heights, FL 32656-6143
Mailing address
3631 SE 2ND Ave
Keystone Heights, FL 32656-6143
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250114001997 | FL | Order and Referring Only - Pediatric Medicine | 3476081712 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39087 | FL | MD | Pediatrics Physician |
Interoperability endpoints
- mcolaw709440@direct.shands.ufl.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1386499770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3631 SE 2ND AVE",
"city": "KEYSTONE HEIGHTS",
"state": "FL",
"postal_code": "326566143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3631 SE 2ND AVE",
"city": "KEYSTONE HEIGHTS",
"state": "FL",
"postal_code": "326566143",
"telephone_number": "386-546-1637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLAW",
"first_name": "MADISON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-19",
"last_updated": "2024-04-19",
"certification_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "39087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keystone Heights, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.