Individual provider Active NPI

Beverly Ann Collins, FNP

  • Gerontology Nurse Practitioner
  • Hendersonville, NC
National Provider Identifier
1477551919
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0006-00107 Issued in NC
Practice address
510 Balsam Rd
Hendersonville, NC 28792-5703
Phone
(828) 693-4431
Fax
(828) 693-4431
NPI assigned
Jul 8, 2005
Last updated
Jun 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0006-00107 NC Primary

Addresses

Primary practice location

510 Balsam Rd
Hendersonville, NC 28792-5703

Mailing address

PO Box 2570
Hendersonville, NC 28793-2570
Phone (828) 693-4431

Other identifiers 1

IdentifierTypeStateIssuer
500010194OtherRAILROAD MEDICARE B

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200511001827 CA Practitioner - Nurse Practitioner 5991836264 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Podiatry Care IncGroup PAC ID 6507256708, 5 clinicians

Practice addresses (Care Compare)

1845 W Redlands Blvd
Suite 104
Redlands, CA 92373-3125
Phone (909) 244-7430

Merit-based Incentive Payment System (MIPS)

Final score
22.01 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0006-00107NCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carrasco Podiatry Corporation CurrentSince May 1, 2021 Accepting new patients
Providence Podiatry Care, Inc CurrentSince Oct 29, 2021 Accepting new patients
Senior Medical Associates, Inc. CurrentSince Apr 1, 2020 Accepting new patients
WNC Surgical Associates PLLC Past Accepting new patients

Locations

10621 Church St
Ste 120
Rch Cucamonga, CA 91730
Phone (909) 944-0481

2810 Camino del Rio S
Ste 102
San Diego, CA 92108
Phone (619) 299-1419

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

Organizations & group practices 4

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1477551919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2570",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287932570",
            "telephone_number": "828-693-4431",
            "fax_number": "828-693-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BALSAM RD",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287925703",
            "telephone_number": "828-693-4431",
            "fax_number": "828-693-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "0006-00107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE B",
            "identifier": "500010194",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

Verify at the official NPI Registry.