Jerry C Collado, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R862534 Issued in MS

Practice address

6919 Old Canton Rd
Ridgeland, MS 39157-1268

Phone

(601) 956-0911

Fax

(601) 957-8439

NPI assigned

May 28, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcollado10747@ummc.direct-ci.com
• Direct secure messaging: jerrycollado@nmhs.medalliesdirect.net

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.

• North Mississippi Medical Center Inc

  • Psychologist
  • Tupelo, MS
  • NPI 1972608347
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD
• North Mississippi Medical Center, Inc.

  • Nurse Practitioner
  • Tupelo, MS
  • NPI 1396177622
  NPD

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1407081862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "JMM SUITE 2525",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-9528",
            "fax_number": "601-984-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6919 OLD CANTON RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571268",
            "telephone_number": "601-956-0911",
            "fax_number": "601-957-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLADO",
        "first_name": "JERRY",
        "middle_name": "C",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R862534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "302I502230",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Suzanne Cockrell Davis, FNP
• Jerrie Renae Cohill, COTA
• Karrie Coker, OT
• Sarah Annette Cole
• Teresa Coleman-Moore
• Charlene Hooper Collier, MD, MPH, MHS
• Kenneth Collins, OT
• Kathryn Collums, PT
• Color Me Jazzy
• Committed Care Personal Care Service, LLC

• Family Nurse Practitioner in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.