Mallory J Collins, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP0265872 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 273-5501

NPI assigned

Aug 14, 2012

Sex

Female

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 1

Other names 1

• Mallory J Kebbel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1669729208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13833",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013833",
            "telephone_number": "352-265-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MALLORY",
        "middle_name": "J",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP0265872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006473100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "KEBBEL",
            "middle_name": "J",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dennis Patrick Collins, MD
• Jacquenette Collins
• Jeremiah Dorrington Collins IV
• John Collins
• Lacreasha Y Collins
• Nancy Christiana Collins
• Shelley Renee Collins, RN
• Shelley Wells Collins, MD
• Veronica Collins
• William O Collins, MD

• Nurse Practitioner in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.