Michelle Carolyn Collymore

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

9691 Issued in SC

Practice address

3402 Maybank St
Columbia, SC 29204-2858

Phone

(803) 728-0675

Fax

(803) 435-0786

NPI assigned

Feb 13, 2020

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1558994061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 MAYBANK ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042858",
            "telephone_number": "803-728-0675",
            "fax_number": "803-435-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 MAYBANK ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042858",
            "telephone_number": "803-728-0675",
            "fax_number": "803-435-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLYMORE",
        "first_name": "MICHELLE",
        "middle_name": "CAROLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "9691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald L Collins, MD
• Susan Collins, PSYD
• Tiffany Collins, LPC
• Toya Renee Collins, LPC-A
• Tracey Moats Collins, RPH
• Ricardo Colon II, RN
• Colonial Family Practice & Ambulatory Care Center
• Colonial Family Practice NE
• Colonial Family Practice, LLC
• Bailey Colquitt, LPC

• Home Health Agency in Columbia, SC
• Providers in Columbia, SC by specialty
• Home Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.