Jacqueline Anne Colligan

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

48234 Issued in TX

Practice address

2411 Fountain View Dr
Suite 200
Houston, TX 77057-4817

Phone

(713) 458-4185

NPI assigned

Jan 4, 2007

Last updated

Aug 31, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Physicians Network PLLCGroup PAC ID 5496029407, 218 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Independent Physicians Network PLLC

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1396274676
  Medicare reassignment Care Compare group NPD
• Pediatric Dentistry of Keller PLLC

  • Pediatric Dentistry
  • Keller, TX
  • NPI 1750934253
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1912054628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574832",
            "telephone_number": "713-620-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR",
            "address_2": "SUITE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574817",
            "telephone_number": "713-458-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIGAN",
        "first_name": "JACQUELINE",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "48234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002473901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430039901",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2117297",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX-BLUE SHIELD",
            "identifier": "81171H",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerry Collier
• Norri J Collier, D.C.
• Samuel J Collier, M.D.
• Shannon Marie Collier, LCSW-S
• Taylor Samone Collier
• Collins National Behavioral Health, Inc
• Chelley Collins-Anderson, LCSW
• Millicent Collins-Lott
• Aaron Chritopher Collins
• Alexa Marie Collins, PA-C

• Certified Registered Nurse Anesthetist in Houston, TX
• Providers in Houston, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.