Kelli Collins, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

053041 Issued in CT

Practice address

181 Emmett St W
Battle Creek, MI 49037-2963

Phone

(269) 966-2600

Fax

(269) 965-4773

NPI assigned

Apr 28, 2011

Last updated

Aug 12, 2015By 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 names 1

• Kelli Broekema Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1598056251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 EMMETT ST W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490372963",
            "telephone_number": "269-966-2600",
            "fax_number": "269-965-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 EMMETT ST W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490372963",
            "telephone_number": "269-966-2600",
            "fax_number": "269-965-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KELLI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "053041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "BROEKEMA",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carrie Lynn Coleman, PH.D, BCBA-D
• Lauryn Coleman
• Marc C Colitti, LPC
• Angela E Collins
• Brendan M Collins, DO
• Shannon Marie Collver, PA-C
• Colon and Rectal Surgery Center PC
• William J Comai, DO
• John Comeau
• Comforts of Home Counseling & Care Management LLC

• Pediatrics Physician in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.