Individual provider Active NPI

Miakoda Wolin-Collins, ARNP

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1457811358
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ARNP11001500 Issued in FL
Practice address
2605 W Swann Ave Ste 600
Tampa, FL 33609-4044
Phone
(813) 876-7073
Fax
(813) 877-1277
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ARNP11001500 FL Primary

Addresses

Primary practice location

2605 W Swann Ave Ste 600
Tampa, FL 33609-4044

Mailing address

2605 W Swann Ave Ste 600
Tampa, FL 33609-4044
Phone (813) 876-7073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20211012000561 GA Practitioner - Nurse Practitioner 8224370200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP11001500FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Sep 30, 2021 Accepting new patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Sep 30, 2021 Accepting new patients

Locations

780 E Oglethorpe Hwy
Hinesville, GA 31313
Phone (912) 332-7262

101 Saint Josephs Candler Dr
Ste 100
Pooler, GA 31322
Phone (912) 450-1945

361 Commercial Dr
Savannah, GA 31406
Phone (912) 355-6221

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1457811358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 W SWANN AVE STE 600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094044",
            "telephone_number": "813-876-7073",
            "fax_number": "813-877-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 W SWANN AVE STE 600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094044",
            "telephone_number": "813-876-7073",
            "fax_number": "813-877-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLIN-COLLINS",
        "first_name": "MIAKODA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ARNP11001500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.