Individual provider Active NPI

Anthony Scott Collias, DC

  • Chiropractor
  • Charleston, WV
National Provider Identifier
1659477248
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
752 Issued in WV
Practice address
4710 Chimney Dr Ste H
Charleston, WV 25302-4841
Phone
(304) 965-2458
Fax
(304) 965-2258
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 752 WV Primary

Addresses

Primary practice location

4710 Chimney Dr Ste H
Charleston, WV 25302-4841

Mailing address

4710 Chimney Dr Ste H
Charleston, WV 25302-4841
Phone (304) 965-2458

Other identifiers 6

IdentifierTypeStateIssuer
001722786OtherWVBC/BS
1042963OtherCIGNA
149986OtherCARELINK
2204007-001MedicaidWV
1059093OtherWVBRICKSTREET
7853274OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120419000800 WV Practitioner - Chiropractic 3072619923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4710 Chimney Dr
Suite D
Charleston, WV 25302-4841
Phone (304) 965-2458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
752WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elk Valley Health & Wellness Chiropractor CurrentSince Jan 2, 2007 Accepting new patients
Elk Valley Physical Therapy Inc PastSince Apr 23, 2016 Accepting new patients
Valley Chiropractic PLLC Chiropractor PastSince Jan 1, 2011 Accepting new patients

Locations

4710 Chimney Dr
Ste D
Charleston, WV 25302
Phone (304) 965-2458

4710 Chimney Dr
Charleston, WV 25302

4710 Chimney Dr
Ste H
Charleston, WV 25302
Phone (304) 935-2513

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1659477248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 CHIMNEY DR STE H",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253024841",
            "telephone_number": "304-965-2458",
            "fax_number": "304-965-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 CHIMNEY DR STE H",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253024841",
            "telephone_number": "304-965-2458",
            "fax_number": "304-965-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIAS",
        "first_name": "ANTHONY",
        "middle_name": "SCOTT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "001722786",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1042963",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARELINK",
            "identifier": "149986",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2204007-001",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRICKSTREET",
            "identifier": "1059093",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7853274",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.