Individual provider Active NPI

Colin Lee Gallien, APRN

  • Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1881228476
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11006272 Issued in FL
Practice address
25 Doctors Dr.
Medical Plaza 2
Panama City, FL 32405-4520
Phone
(850) 767-2455
Fax
(850) 767-2790
NPI assigned
Feb 24, 2020
Last updated
Nov 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11006272 FL Primary

Addresses

Primary practice location

25 Doctors Dr.
Medical Plaza 2
Panama City, FL 32405-4520

Mailing address

PO Box 370
Fortson, GA 31808-0370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200404000251 FL Practitioner - Nurse Practitioner 5890124390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hughston Clinic Southeast PCGroup PAC ID 9234423971, 48 clinicians

Practice addresses (Care Compare)

25 Doctors Dr
Panama City, FL 32405-4520
Phone (850) 767-2455

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hughston Clinic Southeast PC CurrentSince Oct 1, 2022 Accepting new patients
Hughston Clinic Southeast PC CurrentSince Oct 1, 2022 Accepting new patients

Locations

341 Racetrack Rd NW
Ste B
Fort Walton Beach, FL 32547
Phone (850) 226-8112

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

25 Doctors Dr
Panama City, FL 32405
Phone (850) 763-9523

25 Doctors Dr
#2
Panama City, FL 32405
Phone (850) 767-2455

Interoperability endpoints

  • Direct secure messaging: colin.gallien.1@321.direct.athenahealth.com

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 3

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": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1881228476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "fax_number": "706-494-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 DOCTORS DR.",
            "address_2": "MEDICAL PLAZA 2",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054520",
            "telephone_number": "850-767-2455",
            "fax_number": "850-767-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLIEN",
        "first_name": "COLIN",
        "middle_name": "LEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11006272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.