Keitheon Raymone Collins, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1925 Berrybrook Dr
Ft Worth, TX 76134-8403

Phone

(214) 930-0889

NPI assigned

Oct 1, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1962220616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 E BETTERAVIA RD # 201",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547023",
            "telephone_number": "805-621-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 BERRYBROOK DR",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761348403",
            "telephone_number": "214-930-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KEITHEON",
        "middle_name": "RAYMONE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle R Collins
• Demertria Shondraya Collins
• Helena M Collins
• Henry Lee Collins, CSA
• Joseph Collins, PHARM.D
• Kenneth Victor Collins, ACNP
• Leonardtine Y Collins
• Linda L Collins, LPC
• Mark F. Collins, M.D.
• Meagan Collins, FNP-C

• Medical Physician Assistant in Ft Worth, TX
• Providers in Ft Worth, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.