Ross E Collins Jr., M.D.
Individual provider Active NPI Child & Adolescent Psychiatry Physician · Tupelo, MS
NPI 1508893074 · NPPES record last updated Jan 11, 2013
Key facts
- NPI
- 1508893074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child & Adolescent Psychiatry Physician 2084P0804X
- License
- MD0000016359 (TN)
- Practice address
- 2434 S Eason Blvd
Tupelo, MS 38804-6942 - Phone
- (662) 844-1717
- Fax
- (662) 680-5129
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- University of Tennessee, HSC, College of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Northeast Mental Health-Mental Retardation Commission
Practice addresses (Care Compare)
499 Gloster Creek VLG
Tupelo, MS 38801-4600
Phone (662) 844-1717
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040806000594 | MS | Practitioner - Psychiatry | 2961474440 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0000016359 | TN | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Mental Health-Mental Retardation Commission | Current |
Accepting new patients | |
| Northeast Mental Health-Mental Retardation Commission | Current |
Accepting new patients | |
| Northeast Mental Health/Mental Retardation Commission | Current | Accepting new patients | |
| Wellness Clinic, P.C. | Past | Accepting new patients |
Locations
2434 S Eason Blvd
Tupelo, MS 38804
Phone (662) 640-4595
499 Gloster Creek Vlg
Ste A3
Tupelo, MS 38801
Phone (662) 640-4595
Interoperability endpoints
- ross.collins.1@15074.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD0000016359 | TN | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD0000016359 | TN | Yes |
Addresses
Primary practice location
2434 S Eason Blvd
Tupelo, MS 38804-6942
Mailing address
2434 S Eason Blvd
Tupelo, MS 38804-6942
Phone (662) 844-1717
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00010869 | Medicaid | MS |
Other providers in Tupelo, MS
- Alicia Collins
- Curtis Lynn Collins
- Jana Collins
- Joseph Cason Collins
- Robert Collins
- Sara Collins
- Sarah Collins
- Taylor Irby Collins
- Jennifer Colyer
- Abby Comer
All providers in Tupelo, MS · Child & Adolescent Psychiatry Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.