Active NPI
Collin D Rardon, RN
- Registered Nurse
- Kirksville, MO
National Provider Identifier
1417697293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 2019027148
- Practice address
- 900 E Laharpe St
Kirksville, MO 63501-4520 - Phone
- (660) 665-1962
- NPI assigned
- Mar 30, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2019027148 | MO | Primary |
Addresses
Primary practice location
900 E Laharpe St
Kirksville, MO 63501-4520
Mailing address
1601 Old South River Rd
Saint Charles, MO 63303-4120
Phone (636) 246-1210
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019027148 | MO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1417697293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 OLD SOUTH RIVER RD",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633034120",
"telephone_number": "636-246-1210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 E LAHARPE ST",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "635014520",
"telephone_number": "660-665-1962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RARDON",
"first_name": "COLLIN",
"middle_name": "D",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-30",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2019027148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirksville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.