Individual provider Active NPI

Justin Mark Collins, M.M.SC.

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1871850560
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
6573 Issued in GA
Practice address
550 Peachtree St
Atlanta, GA 30308
Phone
(404) 686-4411
NPI assigned
Apr 18, 2012
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 6573 GA Primary

Addresses

Primary practice location

550 Peachtree St
Atlanta, GA 30308

Mailing address

550 Peachtree St
Atlanta, GA 30308
Phone (046) 864-4114

Other practice location 1

1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone (770) 719-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121019000036 GA Practitioner - Anesthesiology Assistant 5799935250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Emory University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (800) 242-1131

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6573GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Anesthesia Associates, L.L.C CurrentSince Oct 1, 2012 Accepting new patients
Piedmont Anesthesia LLC CurrentSince Mar 8, 2025 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1871850560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30308",
            "telephone_number": "046-864-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30308",
            "telephone_number": "404-686-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 Highway 54 W",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302144526",
            "country_code": "US",
            "telephone_number": "770-719-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JUSTIN",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "M.M.SC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "6573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.