Active NPI
James David Collins, MD
- Emergency Medicine Physician
- Mount Vernon, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD00046322
- Practice address
- 1415 E Kincaid St
Mount Vernon, WA 98274-4126 - Phone
- (360) 424-4111
- Fax
- (360) 428-2457
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD00046322 | WA | Primary |
Addresses
Primary practice location
1415 E Kincaid St
Mount Vernon, WA 98274-4126
Mailing address
505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8463523 | Medicaid | WA | |
| 0218213 | Other | WA | LIWA |
| 3076CO | Other | WA | BSWA |
| 0215339 | Other | WA | LIWA |
| 5979CO | Other | WA | BSWA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040831001113 | GA | Practitioner - Emergency Medicine | 0840265039 | Reassigns benefits to 1 organization |
| I20121203000503 | TN | Practitioner - Emergency Medicine | 0840265039 | Reassigns benefits to 3 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current | Accepting new patients |
| Emergency Coverage, LLC | Emergency Medicine | Current | Accepting new patients |
| App of Tennessee Ed, PLLC | Emergency Medicine | Current | Accepting new patients |
| Northwest Physician Associates, Apc | Emergency Medicine | Past | Accepting new patients |
Locations
1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115
110 Hospital Dr
Jefferson Cty, TN 37760
Phone (865) 471-2431
9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000
10820 Parkside Dr
Knoxville, TN 37934
Phone (865) 218-7011
1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244
907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818
7565 Dannaher Dr
Powell, TN 37849
Phone (865) 545-8000
Organizations & group practices 4
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.
-
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-
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
Emergency Medicine, GA, TN
-
- Emergency Medicine Physician
- Maysville, KY
- NPI 1356379382
Emergency Medicine, TN
-
- Emergency Medicine Physician
- Federal Way, WA
- NPI 1407127442
Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211500800000",
"number": "1629005384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 S 336TH ST",
"address_2": "SUITE 600",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980036328",
"telephone_number": "253-838-6180",
"fax_number": "253-838-6418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 E KINCAID ST",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982744126",
"telephone_number": "360-424-4111",
"fax_number": "360-428-2457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "JAMES",
"middle_name": "DAVID",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2008-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WA",
"license": "MD00046322",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8463523",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0218213",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "3076CO",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0215339",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "5979CO",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.