Active NPI
Colletta Lavina Redmon
- Family Nurse Practitioner
- Monroe, NC
National Provider Identifier
1790944049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 630555
- Practice address
- 404 S Sutherland Ave
Monroe, NC 28112-5060 - Phone
- (704) 291-9267
- NPI assigned
- Jun 3, 2008
- Last updated
- Jul 22, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 630555 | NC | Primary |
Addresses
Primary practice location
404 S Sutherland Ave
Monroe, NC 28112-5060
Mailing address
193 Redmon Rd
Harmony, NC 28634-9249
Phone (980) 378-3716
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000000 | NC | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1790944049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "193 REDMON RD",
"city": "HARMONY",
"state": "NC",
"postal_code": "286349249",
"telephone_number": "980-378-3716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 S SUTHERLAND AVE",
"city": "MONROE",
"state": "NC",
"postal_code": "281125060",
"telephone_number": "704-291-9267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDMON",
"first_name": "COLLETTA",
"middle_name": "LAVINA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-03",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "630555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.