Individual provider Active NPI

Michael Brandon McCollum, DPM

  • Foot Surgery Podiatrist
  • Montgomery, AL
National Provider Identifier
1720510753
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
391 Issued in AL
Practice address
7085 Sydney Curv
Montgomery, AL 36117-3509
Phone
(646) 830-6502
NPI assigned
Mar 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 391 AL Primary

Addresses

Primary practice location

7085 Sydney Curv
Montgomery, AL 36117-3509

Mailing address

7085 Sydney Curv
Montgomery, AL 36117-3509
Phone (646) 830-6502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230911000291 AL Practitioner - Podiatry 9436513462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Specialty Physicians LLCGroup PAC ID 6507288263, 3 clinicians

Practice addresses (Care Compare)

7085 Sydney Curv
Montgomery, AL 36117-3509
Phone (334) 246-4774

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Troy, AL, CCN 017324
  • Amedisys Home Health of Montgomery Home health agency, Montgomery, AL, CCN 017319
  • Baptist Medical Center East Hospital, Montgomery, AL, CCN 010149

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue70
Removal of nail tissue274
Removal or shaving of skin growth66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
391ALMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Specialty Physicians LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

7085 Sydney Curv
Montgomery, AL 36117
Phone (334) 246-4774

Interoperability endpoints

  • Direct secure messaging: michael.mccollum.1@21340.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1720510753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7085 SYDNEY CURV",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173509",
            "telephone_number": "646-830-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7085 SYDNEY CURV",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173509",
            "telephone_number": "646-830-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "MICHAEL",
        "middle_name": "BRANDON",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "AL",
            "license": "391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.