Individual provider Active NPI

Kaitlin S Collins, MS, NP

  • Nurse Practitioner
  • Providence, RI
National Provider Identifier
1790912400
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN00555 Issued in RI
Practice address
1085 N Main St
Providence, RI 02904-5719
Phone
(401) 415-4618
Fax
(401) 415-4348
NPI assigned
Jun 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN00555 RI Primary
Nurse Practitioner 363L00000X RN-TEMP0511 MA
Adult Health Nurse Practitioner 363LA2200X 30 305129 NY

Addresses

Primary practice location

1085 N Main St
Providence, RI 02904-5719

Mailing address

1085 N Main St
Providence, RI 02904-5719
Phone (401) 415-4618

Other practice location 1

1324 Belmont St Ste 202
Brockton, MA 02301-4435
Phone (401) 415-4618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140514000341 RI Practitioner - Nurse Practitioner 0143401414 Reassigns benefits to 1 organization
I20201105000867 MA Practitioner - Nurse Practitioner 0143401414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1085 N Main St
Providence, RI 02904-5719
Phone (401) 415-4275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN-TEMP0511MAMDNurse Practitioner
30 305129NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hopehealth Hospice & Palliative Care CurrentSince Mar 3, 2014 Accepting new patients
Hopehealth Hospice & Palliative Care CurrentSince Mar 3, 2014 Accepting new patients

Locations

10 Emory St
Attleboro, MA 02703
Phone (401) 415-4618

1324 Belmont St
Ste 202
Brockton, MA 02301
Phone (401) 415-4618

1085 N Main St
Providence, RI 02904
Phone (401) 415-4200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1790912400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045719",
            "telephone_number": "401-415-4618",
            "fax_number": "401-415-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045719",
            "telephone_number": "401-415-4618",
            "fax_number": "401-415-4348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1324 Belmont St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023014435",
            "country_code": "US",
            "telephone_number": "401-415-4618",
            "fax_number": "401-415-4348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KAITLIN",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "MS, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN00555",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN-TEMP0511",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "30 305129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.