Collins Eye Clinic, L.L.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

114662 Issued in MO

Legal business name

COLLINS EYE CLINIC, L.L.C.

Practice address

1342 E Primrose St
Suite B
Springfield, MO 65804-4279

Phone

(417) 869-3200

Fax

(417) 869-3212

NPI assigned

Aug 17, 2006

Organization subpart

No

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

Authorized official

Name

Deann R Edelstein

Title

Practice Manager

Phone

(417) 869-3200

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO, AR2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Warren Patrick Collins, M.D.

  • Ophthalmology Physician
  • Springfield, MO
  • NPI 1043220874

  AR, MO, Ophthalmology

  Medicare reassignment NPD

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1821101189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 E PRIMROSE ST",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044279",
            "telephone_number": "417-869-3200",
            "fax_number": "417-869-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1342 E PRIMROSE ST",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044279",
            "telephone_number": "417-869-3200",
            "fax_number": "417-869-3212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Carter St",
            "address_purpose": "LOCATION",
            "city": "Berryville",
            "state": "AR",
            "postal_code": "726164303",
            "country_code": "US",
            "telephone_number": "417-869-3200",
            "fax_number": "417-869-3212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 W US Highway 60 Ste 3",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "MO",
            "postal_code": "655488542",
            "country_code": "US",
            "telephone_number": "417-869-3200",
            "fax_number": "417-869-3212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1605 Martin Springs Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012980",
            "country_code": "US",
            "telephone_number": "417-869-3200",
            "fax_number": "417-869-3212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLLINS EYE CLINIC, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "EDELSTEIN",
        "authorized_official_first_name": "DEANN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "417-869-3200"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "114662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203814702",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169437002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles F Coller, ED.D
• Kari Collier, MSN, APRN, FNP-C
• Leanna Marie Collier
• Maribeth Collier
• Nicole M Collier, MS, LPC
• Celeste Collins
• Douglass D. Collins, MD
• Jacey Lauren Collins, PLPC
• Jesse D Collins, CRNA
• Lauren Krista Collins

• All providers in Springfield, MO
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.