R. Douglas McCollum, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

2101 47TH St
Moline, IL 61265-3663

Phone

(309) 762-3931

Fax

(309) 762-4938

NPI assigned

Mar 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Advanced Foot & Ankle Center Inc

  • Foot & Ankle Surgery Podiatrist
  • Moline, IL
  • NPI 1235728510
  NPD (past)
• McCollum Psychology, PC

  • Psychologist
  • Moline, IL
  • NPI 1275616484
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1740319821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 47TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653663",
            "telephone_number": "309-762-3931",
            "fax_number": "309-762-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 47TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653663",
            "telephone_number": "309-762-3931",
            "fax_number": "309-762-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "R.",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "00213",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IA",
            "license": "00512",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "58957",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Ann McCarty, FNP
• Laura McCaughey
• Carley McCloud, NP
• Heather Lane McCollough, ARNP
• McCollum Psychology, PC
• Amanda Marie McCurdy, CRNA
• Joseph McEachern
• Allison M McGraw, MOT
• Sharon Kay McKean, PTA
• Mitchel Matthew McKenzie, M.D.

• Psychologist in Moline, IL
• Providers in Moline, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.