Colleen Patricia McNicholas, DO

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

2011003938 Issued in MO

Practice address

4901 Forest Park Ave Ste 710
Ste 710
Saint Louis, MO 63108-1402

Phone

(314) 362-4211

Fax

(314) 362-0049

NPI assigned

Jul 1, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colleen.mcnicholas.1@16251.direct.athenahealth.com

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.

• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1760422265

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky

  • Non-Surgical Family Planning Clinic/Center
  • Honolulu, HI
  • NPI 1558424473

  Gynecology

  NPD (past)

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1962664730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "C B 8064",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-454-7882",
            "fax_number": "314-222-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 FOREST PARK AVE STE 710",
            "address_2": "STE 710",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081402",
            "telephone_number": "314-362-4211",
            "fax_number": "314-362-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNICHOLAS",
        "first_name": "COLLEEN",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2011003938",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MO",
            "license": "2011003938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962664730",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler McNeil, DC
• Carey McNeilly, LPC
• Daniel F. McNeive, M.D.
• Katharine Margaret McNelly, FNP
• Kyle P McNerney, MD
• Allison McNiell, PA-C
• Annie McNulty-Jennings, CRNA
• Tanya R McNulty, CRMA/CHW-C
• Nathalia McPeak
• Susan L McPeak, CRNA

• Gynecology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.