Amber L Collum, PAC
Individual provider Active NPI Physician Assistant · Vinton, IA
NPI 1730166802 · NPPES record last updated Oct 25, 2011
Key facts
- NPI
- 1730166802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 001495 (IA)
- Practice address
- 1803 C Ave
Vinton, IA 52349-1691 - Phone
- (319) 472-2304
- Fax
- (319) 472-4579
- NPI assigned
- Dec 29, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100220000129 | IA | Practitioner - Physician Assistant | 1557405156 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| St Luke'S Jones Regional Medical Center | Current |
Accepting new patients | |
| St Luke'S Jones Regional Medical Center | Current |
Accepting new patients |
Locations
1795 Highway 64 E
Anamosa, IA 52205
Phone (319) 462-6161
1795 Highway 64 E
Ste 1
Anamosa, IA 52205
Phone (319) 481-6291
1803 C Ave
Vinton, IA 52349
Phone (319) 472-2304
Interoperability endpoints
- acollum231555@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001495 | IA | Yes |
Addresses
Primary practice location
1803 C Ave
Vinton, IA 52349-1691
Mailing address
1803 C Ave
Vinton, IA 52349-1691
Phone (515) 471-9372
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PO00055841 | Other | IA | RR MEDICARE |
Other providers in Vinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.