Individual provider Active NPI

Sangeetha Varghese McCollum, PA-C

  • Medical Physician Assistant
  • Smyrna, TN
National Provider Identifier
1407001795
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1600 Issued in TN
Practice address
300 Stonecrest Blvd Ste 100
Smyrna, TN 37167-5689
Phone
(615) 223-9502
Fax
(615) 223-9596
NPI assigned
Dec 1, 2008
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1600 TN Primary
Internal Medicine Physician 207R00000X 1600 TN

Addresses

Primary practice location

300 Stonecrest Blvd Ste 100
Smyrna, TN 37167-5689

Mailing address

300 Stonecrest Blvd Ste 100
Smyrna, TN 37167-5689
Phone (615) 223-9502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20091215000194 TN Practitioner - Physician Assistant 7517007057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Group - Stonecrest FP IncGroup PAC ID 7214832476, 7 clinicians

Practice addresses (Care Compare)

300 Stonecrest Blvd
Smyrna, TN 37167-5170
Phone (615) 223-9502

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.59 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
71.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1600TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis Specialists of Nashville Inc PastSince Nov 13, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sangeetha.mccollum@hca1.eclinicaldirectplus.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 1

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": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1407001795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD STE 100",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675689",
            "telephone_number": "615-223-9502",
            "fax_number": "615-223-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD STE 100",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675689",
            "telephone_number": "615-223-9502",
            "fax_number": "615-223-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "SANGEETHA",
        "middle_name": "VARGHESE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "1600",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "1600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

Verify at the official NPI Registry.