NPIMap

Individual provider Active NPI

Shelli Lynn Collingham, MD

  • Hospitalist Physician
  • Richland, WA
National Provider Identifier
1760479273
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD60264301 Issued in WA
Practice address
888 Swift Blvd.
Richland, WA 99352
Phone
(509) 942-4611
Fax
(509) 942-3115
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60264301 WA
Hospitalist Physician 208M00000X MD60264301 WA Primary

Addresses

Primary practice location

888 Swift Blvd.
Richland, WA 99352

Mailing address

560 Gage Blvd
Suite 203
Richland, WA 99352-8650
Phone (509) 942-3627

Other identifiers 2

IdentifierTypeStateIssuer
1760479273MedicaidWA
025904OtherWAL&I KRMC GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20120515000680 WA Practitioner - HospitalistPractitioner - Internal Medicine 5991820185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1105 Dale Ave
Benton City, WA 99320-8872
Phone (509) 588-4075

200 Prosser Health Dr
Prosser, WA 99350-7832
Phone (509) 788-6022

723 Memorial St
Prosser, WA 99350-1524
Phone 50978655995599

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26756AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prosser Public Hospital District of Benton County CurrentSince Jun 1, 2021 Accepting new patients
Prosser Public Hospital District of Benton County Current Accepting new patients
Kadlec Regional Medical Center Internal Medicine Current Accepting new patients
Kadlec Regional Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Kadlec Regional Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Prosser Public Hospital District of Benton County CurrentSince Jun 1, 2021 Accepting new patients
Hospitalists of Arizona, Inc Internal Medicine Past Accepting new patients

Locations

1105 Dale Ave
Benton City, WA 99320
Phone (509) 588-4075

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

560 Gage Blvd
Ste 203
Richland, WA 99352
Phone (509) 942-3135

Organizations & group practices 7

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 1

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1760479273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD",
            "address_2": "SUITE 203",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993528650",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 SWIFT BLVD.",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-942-4611",
            "fax_number": "509-942-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINGHAM",
        "first_name": "SHELLI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60264301",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD60264301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760479273",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I KRMC GROUP NUMBER",
            "identifier": "025904",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.