Samuel Brown Collins, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

9400758 Issued in NC

Practice address

4402 Shipyard Blvd
Wilmington, NC 28403-6161

Phone

(910) 452-1400

Fax

(910) 332-1072

NPI assigned

Jun 14, 2005

Last updated

Nov 24, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Brody School of Medicine at East Carolina University, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medac Health Services PAGroup PAC ID 1254220809, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Medac Health Services, PA

  dba Medac Urgent Care

  • Emergency Medicine Physician
  • Wilmington, NC
  • NPI 1356345920
  Medicare reassignment Care Compare group NPD
• Ecep II PA

  • Emergency Medicine Physician
  • Burgaw, NC
  • NPI 1255407680
  Medicare reassignment NPD
• Ecep II PA

  • Emergency Medicine Physician
  • Wilmington, NC
  • NPI 1558755165
  NPD
• Ecep II PA

  • Emergency Medicine Physician
  • Wilmington, NC
  • NPI 1831265263
  NPD
• Medac Health Services, PA

  dba Medac Urgent Care

  • Emergency Medicine Physician
  • Wilmington, NC
  • NPI 1346745098
  NPD
• Pender Memorial Hospital, Incorporated

  dba Novant Health Pender Medical Center

  • Critical Access Hospital
  • Burgaw, NC
  • NPI 1295703130
  NPD (past)

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1669477055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036161",
            "telephone_number": "910-452-1400",
            "fax_number": "910-332-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036161",
            "telephone_number": "910-452-1400",
            "fax_number": "910-332-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "SAMUEL",
        "middle_name": "BROWN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "9400758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912191",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930084654",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "B4543",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0075F",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930077053",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12191",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "01-28698",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret B Collins, MD
• Melissa Anne Collins, FNP-C
• Rachel Collins
• Rebecca Aileen Collins, BA
• Robert Edward Collins Jr., C.O.
• Taylor Nicole Collins, LCSWA
• Nadya Colosimo, DPT
• Columbus Hospitalists P.a
• James Travis Colwell, PHD
• Shawn Thomas Colwell, RNFA

• Emergency Medicine Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.
• 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.