Kimo Cecil Collins, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

28013 Issued in OR

Practice address

727 SE Cass Ave Ste 308
Roseburg, OR 97470-4954

Phone

(541) 530-3016

NPI assigned

Nov 22, 2021

Last updated

Nov 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1821755174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HARVEST LN",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974719269",
            "telephone_number": "541-530-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 SE CASS AVE STE 308",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974704954",
            "telephone_number": "541-530-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KIMO",
        "middle_name": "CECIL",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-22",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "28013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melony A Coleman
• Bernie Richard Collard
• Maddison Nicole Collings
• Carol Lynn Collins, FNP-C
• John William Collins, M.D.
• Molly C Collins, LCSW
• Steven Collins, MA, LPC
• Commonspirit Oregon (CHI Mercy Medical Center)
• Commonspirit Oregon (Mercy Medical Center Roseburg)
• Commonspirit Oregon (CHI Mercy Medical Center)

• Massage Therapist in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.