Individual provider Active NPI

Karen Joan McColl, M.D.

  • Gynecology Physician
  • Vidalia, GA
National Provider Identifier
1467658666
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
053282 Issued in GA
Practice address
101 Harris Industrial Blvd
Suite C
Vidalia, GA 30474-8845
Phone
(912) 537-1014
Fax
(912) 538-1538
NPI assigned
Jun 25, 2007
Last updated
Aug 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 053282 GA Primary

Addresses

Primary practice location

101 Harris Industrial Blvd
Suite C
Vidalia, GA 30474-8845

Mailing address

PO Box 407
Vidalia, GA 30475-0407
Phone (912) 537-4986

Other practice location 1

1707 Meadows Ln Ste A
Vidalia, GA 30474-7201
Phone (912) 537-1014

Other identifiers 1

IdentifierTypeStateIssuer
734884631AMedicaidGA

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

LicenseStateTypeSpecialty
053282GAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Regional Primary Care Corporation Current Accepting new patients
Meadows Regional Medical Center Inc Current Accepting new patients
Family Care Centers Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: karen.mccoll@mrmc.gadirect.net
  • Direct secure messaging: karen.mccoll@srpcc.gadirect.net
  • Direct secure messaging: karen.mccoll1@gadirect.net

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, 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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1467658666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750407",
            "telephone_number": "912-537-4986",
            "fax_number": "912-538-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD",
            "address_2": "SUITE C",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748845",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-1538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1707 Meadows Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304747201",
            "country_code": "US",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-0979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOLL",
        "first_name": "KAREN",
        "middle_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "053282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "734884631A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.