Charles Frederick Collin, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

30897 Issued in NC

Practice address

1918 Randolph Rd
Suite 500
Charlotte, NC 28207-1100

Phone

(704) 364-8100

Fax

(704) 365-2073

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Southeast Surgical Specialists, PLLC

  • Surgery Physician
  • Charlotte, NC
  • NPI 1750323168
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1790721371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD",
            "address_2": "SUITE 130",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071100",
            "telephone_number": "704-364-8100",
            "fax_number": "704-364-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD",
            "address_2": "SUITE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071100",
            "telephone_number": "704-364-8100",
            "fax_number": "704-365-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIN",
        "first_name": "CHARLES",
        "middle_name": "FREDERICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "30897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8923803",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Collective Therapy Corp.
• Collegiate Global Network
• Brittany Collett
• Kayla Nicole Collier-Grant
• Misty L. Collier, LPA
• Olivia Maureen Collington
• Leah Collingwood, LMBT
• Collins Counseling & Consulting PLLC
• Collins Youth Homes, Inc
• Fametta Collins-Darling

• Surgery Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.