Active NPI
Brian Collins
- Registered Dietitian
- Clover, SC
National Provider Identifier
1649872102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L2134
- Practice address
- 1012 Barcelona PL
Clover, SC 29710-1381 - Phone
- (336) 509-1126
- NPI assigned
- Nov 10, 2020
- Last updated
- Dec 18, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | L006279 | NC | |
| Registered Dietitian | 133V00000X | L2134 | SC | Primary |
Addresses
Primary practice location
1012 Barcelona PL
Clover, SC 29710-1381
Mailing address
1012 Barcelona PL
Clover, SC 29710-1381
Phone (336) 509-1126
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L006279 | NC | MD | Registered Dietitian |
| L2134 | SC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nutrition Healthworks LLC | Dietitian, Registered | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608249600000",
"number": "1649872102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1012 BARCELONA PL",
"city": "CLOVER",
"state": "SC",
"postal_code": "297101381",
"telephone_number": "336-509-1126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 BARCELONA PL",
"city": "CLOVER",
"state": "SC",
"postal_code": "297101381",
"telephone_number": "336-509-1126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-10",
"last_updated": "2020-12-18",
"certification_date": "2020-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L006279",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "L2134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clover, SC
- Clover Chiropractic Care, LLC
- Clover Chiropractic LLC
- Clover Family Dentistry, LLC
- Clover Rescue Squad, Inc.
- Clover School District
- Graziella Costa-Stephenson
- Danielle Klett LCSW LLC
- Dawn Vojvoda Davis, DNP, CRNA
- Sandra Defalco, FNP
- Dental Professionals of South Carolina, P.C. (Dental Care of Lake Wylie)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.