NPIMap

Organization Active NPI

R Deaver Collins MD PA

  • Rheumatology Physician
  • Jackson, MS
National Provider Identifier
1780028670
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
AC1150414 Issued in MS
Legal business name
R DEAVER COLLINS MD PA
Practice address
1190 N State St
Suite 302
Jackson, MS 39202-2413
Phone
(601) 353-7090
NPI assigned
Apr 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Authorized official

Name
Dr. Robert Deaver Collins, MD
Title
President
Phone
(601) 353-7090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X AC1150414 MS Primary

Addresses

Primary practice location

1190 N State St
Suite 302
Jackson, MS 39202-2413

Mailing address

1190 N State St
Suite 302
Jackson, MS 39202-2413
Phone (601) 353-7090

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1780028670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST",
            "address_2": "SUITE 302",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022413",
            "telephone_number": "601-353-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST",
            "address_2": "SUITE 302",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022413",
            "telephone_number": "601-353-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R DEAVER COLLINS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DEAVER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-353-7090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MS",
            "license": "AC1150414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.