Individual provider Active NPI

Collette R Fox, MLP

  • Family Nurse Practitioner
  • Shelby, NC
National Provider Identifier
1578842332
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5005221 Issued in NC
Practice address
711 N Dekalb St
Shelby, NC 28150-3911
Phone
(704) 482-1482
Fax
(704) 480-6012
NPI assigned
Aug 11, 2011
Last updated
Aug 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5005221 NC Primary

Addresses

Primary practice location

711 N Dekalb St
Shelby, NC 28150-3911

Mailing address

711 N Dekalb St
Shelby, NC 28150-3911
Phone (704) 482-1482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110906000057 NC Practitioner - Nurse Practitioner 6901076777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shelby Medical Associates PAGroup PAC ID 2961482435, 9 clinicians

Practice addresses (Care Compare)

711 N Dekalb St
Shelby, NC 28150-3911
Phone (704) 482-1482

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shelby Medical Associates, PA CurrentSince Jul 23, 2011 Accepting new patients
Shelby Medical Associates, P.a. Past Accepting new patients

Locations

711 N DeKalb St
Shelby, NC 28150
Phone (704) 482-1482

Interoperability endpoints

  • Direct secure messaging: collette.fox@smap.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1578842332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N DEKALB ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503911",
            "telephone_number": "704-482-1482",
            "fax_number": "704-480-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N DEKALB ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503911",
            "telephone_number": "704-482-1482",
            "fax_number": "704-480-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "COLLETTE",
        "middle_name": "R",
        "credential": "MLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

Verify at the official NPI Registry.