Colleen Lucia Hartsell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0956 Issued in TN

Practice address

104 Stuart Rd NE
Cleveland, TN 37312-4803

Phone

(423) 476-2464

Fax

(423) 476-1008

NPI assigned

Jul 14, 2006

Last updated

Aug 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Colleen Lucia Just Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1508882580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153 DEPT 40339",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352879387",
            "telephone_number": "706-271-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 STUART RD NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124803",
            "telephone_number": "423-476-2464",
            "fax_number": "423-476-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTSELL",
        "first_name": "COLLEEN",
        "middle_name": "LUCIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "0956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4051092",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "JUST",
            "middle_name": "LUCIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cynthia Jane Harrison, BEHAVIOR TECHNICIAN
• James F Hart, D.O.
• Brenda Hartgrove, LCSW
• Don Charles Harting, M.D.
• Jenna Hartmann, NP
• Rachel La Rea Hatchett, LCSW
• Lindsay L. Hathcock Jr., D.C.
• Robert Hays, PHARMD
• William Augustus Hays, M.D.
• Austin Hazlewood, DO

• Physician Assistant in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.