Active NPI
Zachary Daniel Collett, M.S., ATC, LAT
- Athletic Trainer
- Tahlequah, OK
National Provider Identifier
1932271798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 454
- Practice address
- 600 N Grand Ave
Tahlequah, OK 74464-2301 - Phone
- (918) 456-5511
- Fax
- (918) 458-2339
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 454 | OK | Primary |
Addresses
Primary practice location
600 N Grand Ave
Tahlequah, OK 74464-2301
Mailing address
903 Sheryl St
Tahlequah, OK 74464-8021
Phone (417) 848-1741
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 454 | Other | OK | STATE LICENSURE NUMBER |
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 454 | OK | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932271798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "903 SHERYL ST",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744648021",
"telephone_number": "417-848-1741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N GRAND AVE",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744642301",
"telephone_number": "918-456-5511",
"fax_number": "918-458-2339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLETT",
"first_name": "ZACHARY",
"middle_name": "DANIEL",
"name_prefix": "Mr.",
"credential": "M.S., ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OK",
"license": "454",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSURE NUMBER",
"identifier": "454",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tahlequah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.