Nehdra McCollum

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

NEHDRA MCCOLLUM

Practice address

5008 E 86TH St
Garfield HTS, OH 44125-2000

Phone

(216) 396-8203

NPI assigned

Jun 6, 2016

Last updated

Jun 6, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Nehdra Monique McCollum, 02/18/2016

Title

Independent Provider

Phone

(216) 396-8203

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1942659537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 EAST 86 ST",
            "city": "GARFIELD HTS",
            "state": "OH",
            "postal_code": "44125",
            "telephone_number": "216-396-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 E 86TH ST",
            "city": "GARFIELD HTS",
            "state": "OH",
            "postal_code": "441252000",
            "telephone_number": "216-396-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEHDRA MCCOLLUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "MCCOLLUM",
        "authorized_official_first_name": "NEHDRA",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "INDEPENDENT PROVIDER",
        "authorized_official_telephone_number": "216-396-8203",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "02/18/2016"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.