NPIMap

Individual provider Active NPI

Jonathan Mark Collins, M.D.

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1760445233
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200001102 Issued in NC
Practice address
7903 Providence Rd
Suite 100
Charlotte, NC 28277-9720
Phone
(704) 316-4460
Fax
(704) 316-4466
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200001102 NC Primary

Addresses

Primary practice location

7903 Providence Rd
Suite 100
Charlotte, NC 28277-9720

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840

Other identifiers 1

IdentifierTypeStateIssuer
89131Y8MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081211000783 NC Practitioner - Family Practice 9133280928 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians

Practice addresses (Care Compare)

11530 Providence Rd
Charlotte, NC 28277-2691
Phone (704) 667-0670

332 N Trade St
Suite 2000a
Matthews, NC 28105-1728
Phone (704) 302-8860

4525 Cameron Valley Pkwy
Suite 4100D
Charlotte, NC 28211-4369
Phone (980) 402-1800

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Willowbrooke Court SC Ctr at Matthews Glen Nursing home, Matthews, NC, CCN 345326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200001102NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Health North Market Network LLC Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Aug 6, 2020 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 6, 2020 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network, Inc Family Medicine Past Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

101 E Wt Harris Blvd
Ste 5301
Charlotte, NC 28262
Phone (704) 548-1671

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

7903 Providence Rd
Ste 100
Charlotte, NC 28277
Phone (704) 316-4460

332 N Trade St
Ste 2000A
Matthews, NC 28105
Phone (704) 302-8860

4105 Matthews Mint Hill Rd
Matthews, NC 28105
Phone (704) 316-3095

11304 Hawthorne Dr
Ste 100
Mint Hill, NC 28227
Phone (704) 384-8760

Interoperability endpoints

  • Direct secure messaging: jcollins423063@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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 7

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1760445233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7903 PROVIDENCE RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282779720",
            "telephone_number": "704-316-4460",
            "fax_number": "704-316-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JONATHAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200001102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89131Y8",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.