Individual provider Active NPI

John D Collins, MD

  • Psychologist
  • Jamestown, ND
National Provider Identifier
1417977463
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
203 Issued in ND
Practice address
302 2ND Avenue NW
Jamestown, ND 58401
Phone
(701) 251-6000
Fax
(701) 952-8256
NPI assigned
Jul 20, 2006
Last updated
Jan 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 203 ND Primary

Addresses

Primary practice location

302 2ND Avenue NW
Jamestown, ND 58401

Mailing address

PO Box 5501
Bismarck, ND 58506-5501
Phone (701) 323-6000

Other identifiers 1

IdentifierTypeStateIssuer
10303MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
203NDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck Current Accepting new patients
Medcenter One Health Systems DME Current Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1417977463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5501",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585065501",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 2ND AVENUE NW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "58401",
            "telephone_number": "701-251-6000",
            "fax_number": "701-952-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10303",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, ND

Sources for this page

Verify at the official NPI Registry.