Active NPI
Collin Shanley McLean, PA-C
- Physician Assistant
- Ottawa, IL
National Provider Identifier
1952006934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085009935
- Practice address
- 1100 E Norris Dr
Ottawa, IL 61350-1604 - Phone
- (815) 433-3100
- NPI assigned
- Mar 31, 2023
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085009935 | IL | Primary |
Addresses
Primary practice location
1100 E Norris Dr
Ottawa, IL 61350-1604
Mailing address
525 Houston St
Ottawa, IL 61350-3528
Phone (219) 669-3378
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2860 S Circle Dr
Colorado Springs, CO 80906-4195
Phone (719) 540-2100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Center, LLC | Current | Accepting new patients | |
| Family Care Center, LLC | Physician Assistant | Current | Accepting new patients |
Locations
2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002
10535 Park Meadows Blvd
Ste 200
Lone Tree, CO 80124
Phone (303) 228-8958
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Colorado Springs, CO
- NPI 1790141984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734912000000",
"number": "1952006934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 HOUSTON ST",
"city": "OTTAWA",
"state": "IL",
"postal_code": "613503528",
"telephone_number": "219-669-3378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 E NORRIS DR",
"city": "OTTAWA",
"state": "IL",
"postal_code": "613501604",
"telephone_number": "815-433-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLEAN",
"first_name": "COLLIN",
"middle_name": "SHANLEY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-31",
"last_updated": "2024-12-23",
"certification_date": "2024-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085009935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ottawa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.