Active NPI
Grant Michael Collins, PT
- Physical Therapist
- Poplar Bluff, MO
National Provider Identifier
1457679730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2008020468
- Practice address
- 2166 North Westwood Blvd
Poplar Bluff, MO 63901-2440 - Phone
- (573) 712-2696
- Fax
- (573) 712-2991
- NPI assigned
- May 11, 2010
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2008020468 | MO | Primary |
Addresses
Primary practice location
2166 North Westwood Blvd
Poplar Bluff, MO 63901-2440
Mailing address
2166 N Westwood Blvd
Poplar Bluff, MO 63901-2440
Phone (573) 712-2696
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457679730 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2166 N Westwood Blvd
Poplar Bluff, MO 63901-2440
Phone (573) 712-2696
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.94 of 100
- Quality
- 83.11
- Improvement activities
- 40
- Cost
- 75.65
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008020468 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Rehabilitation, LLC | Physical Therapist | Past | Accepting new patients |
| Select Physical Therapy Holdings, Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Physical Therapist
- Poplar Bluff, MO
- NPI 1225459712
-
- Physical Therapy Clinic/Center
- Poplar Bluff, MO
- NPI 1336869338
-
- Physical Therapy Clinic/Center
- Poplar Bluff, MO
- NPI 1588848618
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773014400000",
"number": "1457679730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2166 N WESTWOOD BLVD",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639012440",
"telephone_number": "573-712-2696",
"fax_number": "573-712-2991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2166 NORTH WESTWOOD BLVD",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639012440",
"telephone_number": "573-712-2696",
"fax_number": "573-712-2991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "GRANT",
"middle_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-11",
"last_updated": "2026-03-09",
"certification_date": "2026-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2008020468",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1457679730",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.