Charles D Collom, MSN, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95013166 Issued in CA

Practice address

1801 Panorama Drive
Student Health and Wellness Center
Bakersfield, CA 93305-9330

Phone

(661) 395-4336

NPI assigned

Jul 8, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

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.

• Kern Community College District

  dba Bakersfield College

  • Local Education Agency (LEA)
  • Bakersfield, CA
  • NPI 1104339761
  NPD (past)

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1508437682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 PANORAMA DR",
            "address_2": "STUDENT HEALTH AND WELLNESS CENTER",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933051299",
            "telephone_number": "661-395-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 PANORAMA DRIVE",
            "address_2": "STUDENT HEALTH AND WELLNESS CENTER",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933059330",
            "telephone_number": "661-395-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLOM",
        "first_name": "CHARLES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MSN, DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennedy Collins
• Laura Louise Collins, FNP
• Lena Deshea Collins
• Natalie Collins
• Shawn Collins
• Thomas Clifford Collord, N.P.
• Colonial Medical Group, Inc.
• Columbus Health Corp
• Columbus Health Mso LLC
• Rhonda Lou Colvin, PA-C

• Nurse Practitioner in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.