Platon J Collipp, M.D.

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

026487 Issued in GA

Practice address

176 Memorial Dr
Jesup, GA 31545-0101

Phone

(912) 427-9378

Fax

(912) 427-9852

NPI assigned

Jul 21, 2005

Last updated

Jan 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Jesup Pediatrics, P.C.

  • Pediatrics Physician
  • Jesup, GA
  • NPI 1316078538
  NPD (past) Authorized official

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1609875590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 MEMORIAL DR",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450101",
            "telephone_number": "912-427-9378",
            "fax_number": "912-427-9852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 MEMORIAL DR",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450101",
            "telephone_number": "912-427-9378",
            "fax_number": "912-427-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIPP",
        "first_name": "PLATON",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "026487",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "GA",
            "license": "026487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00289704A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Nicholas Castleberry, PA-C
• Nicholas Avery Child
• Coastal Serenity Counseling, LLC
• Caitlyn Smith Coleman, M.D.
• Daniel B Collipp, D.O.
• Melanie D Collum, FNP-BC
• Clayton Conners, DPT
• Jay Brandon Cook, M.D.
• William Frederic Corey, PH.D.
• Porche Lashoade Corley, LCSW

• Pediatric Endocrinology Physician in Jesup, GA
• Providers in Jesup, GA by specialty
• Pediatric Endocrinology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.