Individual provider Active NPI

Montika Adhana Collins, BSN, RN, CLC, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Broken Arrow, OK
National Provider Identifier
1902264708
Registry record updated Jun 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
106766 Issued in OK
Practice address
2801 E Kenosha St
#140241
Broken Arrow, OK 74014-6717
Phone
(918) 398-3586
NPI assigned
Feb 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 106766 OK Primary
Registered Nurse 163W00000X 106766 OK
Maternal Newborn Registered Nurse 163WM0102X 106766 OK
Neonatal Intensive Care Registered Nurse 163WN0002X 106766 OK
Low-Risk Neonatal Registered Nurse 163WN0003X 106766 OK

Addresses

Primary practice location

2801 E Kenosha St
#140241
Broken Arrow, OK 74014-6717

Mailing address

PO Box 140241
Broken Arrow, OK 74014-0003
Phone (918) 398-3586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
106766OKMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pcfit LLC Lactation Consultant Current Accepting new patients
Innovations Family Wellness Lactation Consultant Current Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466294400000",
    "number": "1902264708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140241",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740140003",
            "telephone_number": "918-398-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 E KENOSHA ST",
            "address_2": "#140241",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740146717",
            "telephone_number": "918-398-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MONTIKA",
        "middle_name": "ADHANA",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN, CLC, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "OK",
            "license": "106766",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "106766",
            "primary": false
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "OK",
            "license": "106766",
            "primary": false
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "OK",
            "license": "106766",
            "primary": false
        },
        {
            "code": "163WN0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal, Low-Risk",
            "state": "OK",
            "license": "106766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2016; 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.