Active NPI
Shawn Joseph Collier, MD
- Family Medicine Physician
- Daytona Beach, FL
National Provider Identifier
1942053434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- TRN40272
- Practice address
- 201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765 - Phone
- (386) 425-4167
- NPI assigned
- Apr 8, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | TRN40272 | FL | Primary |
Addresses
Primary practice location
201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765
Mailing address
201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240711002210 | FL | Order and Referring Only - Family Practice | 9739624982 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
303 N Clyde Morris Blvd
Daytona BCH, FL 32114-2709
303 N Clyde Morris Blvd
Centralized Credentialing
Daytona Beach, FL 32114-2700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- shawn.joseph.collier.1@16462.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717718400000",
"number": "1942053434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 N CLYDE MORRIS BLVD STE 200",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321142765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 N CLYDE MORRIS BLVD STE 200",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321142765",
"telephone_number": "386-425-4167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLIER",
"first_name": "SHAWN",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-08",
"last_updated": "2024-06-07",
"certification_date": "2024-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "TRN40272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
- Brittney Anne Cole
- Phoebe Cole
- Allen Edward Coleman, MD
- Hugh Aaron Coleman, DO
- James Edward Collie, ACNPC-AG
- Danielle Leanne Collins, MD
- Derrick Collins, M.S.W
- Karyme R Colon
- Comfortable Care Dental Health Professionals, P.a. (Williamson Crossing Dental Care)
- Comfortable Care Dental Health Professionals, P.a. (Tymber Creek Dental Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.