Charles David Collins, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2003-0073 Issued in NM

Practice address

2530 S Telshor Blvd
Suite #207
Las Cruces, NM 88011-4951

Phone

(575) 556-6400

Fax

(575) 556-6405

NPI assigned

Nov 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1790768265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6310",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880066310",
            "telephone_number": "575-556-6400",
            "fax_number": "575-556-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 S TELSHOR BLVD",
            "address_2": "SUITE #207",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114951",
            "telephone_number": "575-556-6400",
            "fax_number": "575-556-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "2003-0073",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NM",
            "license": "2003-0073",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48582832",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00892129",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Collard, OTR/L
• Collective Healing Studio, LLC
• Collette Ceballes, LLC
• Caleb Collette, DO STUDENT
• Autumn Collins
• Danielle Collins
• Edward Michael Collins, APN
• Hayden Collins, DO
• Jasmine Bonet Collins
• Margaret Dorothy Collins, PH.D

• All providers in Las Cruces, NM
• Surgery Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.