Active NPI
Jeanine Shannon-Allison Collier, M.D.
- Psychiatry Physician
- Coos Bay, OR
National Provider Identifier
1427166487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD21368
- Practice address
- 281 Laclair St
Coos Bay, OR 97420-2988 - Phone
- (541) 266-6700
- Fax
- (541) 888-8726
- NPI assigned
- Aug 29, 2006
- Last updated
- Feb 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD21368 | OR | Primary |
Addresses
Primary practice location
281 Laclair St
Coos Bay, OR 97420-2988
Mailing address
281 Laclair St
Coos Bay, OR 97420-2988
Phone (541) 266-6700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 138158 | Medicaid | OR |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD21368 | OR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582070400000",
"number": "1427166487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "281 LACLAIR ST",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974202988",
"telephone_number": "541-266-6700",
"fax_number": "541-888-8726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "281 LACLAIR ST",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974202988",
"telephone_number": "541-266-6700",
"fax_number": "541-888-8726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLIER",
"first_name": "JEANINE",
"middle_name": "SHANNON-ALLISON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "MD21368",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "138158",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.