MCMD, PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19109 Issued in KY

Legal business name

MCMD, PSC

Practice address

1340 Ellis Place
Bowling Green, KY 42104

Phone

(270) 782-6362

Fax

(270) 796-2800

NPI assigned

Apr 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael John Collins, MDNPI 1558333286

Title

Sole Proprietorship

Phone

(270) 782-6362

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael J Collins, M.D.

  • Adult Medicine Physician
  • Bowling Green, KY
  • NPI 1558333286
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1740407667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 ELLIS PLACE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42104",
            "telephone_number": "270-782-6362",
            "fax_number": "270-796-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 ELLIS PLACE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42104",
            "telephone_number": "270-782-6362",
            "fax_number": "270-796-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCMD, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "SOLE PROPRIETORSHIP",
        "authorized_official_telephone_number": "270-782-6362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "19109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "641910",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Sue McKinney
• Katelyn Brooke McKinney, BS, RBT
• Laura McKinney, RPH
• Sarah Elizabeth McMaine-Render
• Baylee R McManus, BS, RBT
• Lucille Lee McMichael, LCSW
• Lawrence McNabb Jr., CRNA
• Tia McNamee
• Pamela April McNaughton, ED.S. ECE
• Shannon McPherson, BHS

• Family Medicine Physician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.