Tracy Collum

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN.CNP.020699 Issued in OH

Practice address

7980 Webster Dr
Lambertville, MI 48144-9618

Phone

(419) 360-0764

NPI assigned

May 11, 2017

Last updated

Sep 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1487181202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 AMES ST",
            "city": "ELMORE",
            "state": "OH",
            "postal_code": "434169736",
            "telephone_number": "419-360-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7980 WEBSTER DR",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481449618",
            "telephone_number": "419-360-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLUM",
        "first_name": "TRACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.020699",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "AAPRN.CNP.020699",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Childress
• Kelly Nicole Chisholm, CNP
• Christian Care Connection LLC
• Citadel Health Equipment Corp.
• Andrew Leon Clark
• Jessica Conrad, LPCC
• Coppernova Health, LLC
• Mindy Christine Costello
• Chelsie Crawford, O.D
• John Arthur Crayne, MD

• Adult Health Nurse Practitioner in Lambertville, MI
• Providers in Lambertville, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.