Individual provider Active NPI

Lynn W Collins, MD

  • Pediatrics Physician
  • Bremerton, WA
National Provider Identifier
1801892112
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00044822 Issued in WA
Practice address
1 Boone Rd
Bremerton, WA 98312-1894
Phone
(425) 304-4138
Fax
(425) 304-4082
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00044822 WA Primary

Addresses

Primary practice location

1 Boone Rd
Bremerton, WA 98312-1894

Mailing address

1 Boone Rd
Bremerton, WA 98312-1894
Phone (425) 304-4138

Other identifiers 1

IdentifierTypeStateIssuer
32516600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170524000929 NJ Practitioner - Pediatric Medicine 4486834553 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Emergency Physician Team Pediatric Associates, P.C. CurrentSince May 1, 2017 Accepting new patients

Locations

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

Organizations & group practices 1

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1801892112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BOONE RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121894",
            "telephone_number": "425-304-4138",
            "fax_number": "425-304-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOONE RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121894",
            "telephone_number": "425-304-4138",
            "fax_number": "425-304-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "LYNN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00044822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32516600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.