Nickolas John Collucci, D.O.

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

OS4153 Issued in FL

Practice address

21 Hospital Dr
Suite 260
Palm Coast, FL 32164-2452

Phone

(386) 586-5344

Fax

(386) 586-5450

NPI assigned

Jul 18, 2006

Last updated

Apr 21, 2010By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vein Treatment Center of Palm Coast P a

  • Phlebology Physician
  • Palm Coast, FL
  • NPI 1689893224
  Authorized official Same address or phone
• Vein Associates, PA

  • Phlebology Physician
  • Heathrow, FL
  • NPI 1326076902
  NPD (past)
• Carolina Vein Center PLLC

  • Phlebology Physician
  • Durham, NC
  • NPI 1952564718
  NPD (past)
• Vein Associates Durham, P.C.

  • Specialist
  • Durham, NC
  • NPI 1497784490
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1811915747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "321360279",
            "telephone_number": "386-586-5344",
            "fax_number": "386-586-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HOSPITAL DR",
            "address_2": "SUITE 260",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642452",
            "telephone_number": "386-586-5344",
            "fax_number": "386-586-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLUCCI",
        "first_name": "NICKOLAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS4153",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "FL",
            "license": "OS4153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dyan J Cole, MS, CF-SLP
• Danessa Lee Coleman
• Collinear
• Collinear Inc (Collinear)
• Jeannette Marie Collins, PT
• Marina Colmone
• Cara M Cologero, COTA/L
• Wallace Mason Combs II, MD
• Comfortable Care Dental Health Professionals (Smiles on Cypress Point)
• Comfortable Care Dental Health Professionals, P.a. (Old Kings Dental Care)

• Phlebology Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Phlebology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.