Individual provider Active NPI

Charolette Collins, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1548022544
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
76883 Issued in NM
Practice address
7007 Wyoming Blvd NE Ste F1
Albuquerque, NM 87109-3983
Phone
(505) 807-3086
NPI assigned
Jan 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 76883 NM Primary

Addresses

Primary practice location

7007 Wyoming Blvd NE Ste F1
Albuquerque, NM 87109-3983

Mailing address

7007 Wyoming Blvd NE Ste F1
Albuquerque, NM 87109-3983
Phone (505) 807-3086

Other practice location 1

695 Bluebird Ln NE
Albuquerque, NM 87122-1805
Phone (505) 280-3936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
76883NMMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Or Psychiatry LLC CurrentSince Feb 18, 2024 Accepting new patients

Locations

7007 Wyoming Blvd NE
Ste F1
Albuquerque, NM 87109
Phone (505) 280-3936

Interoperability endpoints

  • Direct secure messaging: charolette.collins.1@33594.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1548022544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE STE F1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093983",
            "telephone_number": "505-807-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE STE F1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093983",
            "telephone_number": "505-807-3086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "695 Bluebird Ln NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871221805",
            "country_code": "US",
            "telephone_number": "505-280-3936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "CHAROLETTE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "76883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.