Individual provider Active NPI

Cheryl Ann Collins, ARNP - BC

  • Nurse Practitioner
  • Live Oak, FL
National Provider Identifier
1477056976
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP3329912 Issued in FL
Practice address
10820 Marvin Jones Blvd.
Live Oak, FL 32060
Phone
(386) 658-5300
Fax
(386) 658-5130
NPI assigned
Mar 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP3329912 FL Primary
Registered Nurse 163W00000X 3329912 FL

Addresses

Primary practice location

10820 Marvin Jones Blvd.
Live Oak, FL 32060

Mailing address

10820 Marvin Jones Blvd.
Live Oak, FL 32060-3706
Phone (386) 658-5300

Other practice location 1

7207 SW 24th Ave
Gainesville, FL 32607-3706
Phone (352) 333-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190211000499 FL Practitioner - Nurse Practitioner 8729326129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acv Community Services LLCGroup PAC ID 3476462078, 7 clinicians

Practice addresses (Care Compare)

10820 Marvin Jones Blvd
Live Oak, FL 32060-3714
Phone (386) 658-5450

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Lake City, FL, CCN 107420
  • Advent Christian Village Home Care Agency Home health agency, Live Oak, FL, CCN 107576
  • HCA Florida Lake City Hospital Hospital, Lake City, FL, CCN 100156
  • Madison County Memorial Hospital Hospital, Madison, FL, CCN 101311
  • Doctors Memorial Hospital Inc Hospital, Perry, FL, CCN 101314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3329912FLMDRegistered Nurse
ARNP3329912FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acv Community Services LLC CurrentSince Sep 22, 2018 Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1477056976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10820 MARVIN JONES BLVD.",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320603706",
            "telephone_number": "386-658-5300",
            "fax_number": "386-658-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10820 MARVIN JONES BLVD.",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "32060",
            "telephone_number": "386-658-5300",
            "fax_number": "386-658-5130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7207 SW 24th Ave",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326073706",
            "country_code": "US",
            "telephone_number": "352-333-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "credential": "ARNP - BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-12",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3329912",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "3329912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, FL

Sources for this page

Verify at the official NPI Registry.