MARK JEROME COLLINS DO NPI 1295747368

NPI Information

NPI: 1295747368
Provider Name: MARK JEROME COLLINS, DO
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

PECOS Registration: Yes

Address:
5940 E COPPER HILL DR
SUITE B
PRESCOTT VALLEY, AZ
ZIP 86314
Phone: (702) 379-2227
Get Directions

Mark Jerome Collins, DO is a child and adolescent psychiatry psychiatry neurology in Prescott Valley, AZ. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. Mark Jerome Collins, DO NPI is 1295747368. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5940 E COPPER HILL DR
SUITE B
PRESCOTT VALLEY, AZ
ZIP 86314-860
Phone: (702) 379-2227

The NPI 1295747368 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/13/2006 and was last updated on 5/25/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	02847	IOWA	No
2	2084P0800X	Psychiatry & Neurology	Psychiatry	20A12037	CALIFORNIA	No
3	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	766	NEVADA	No
4	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	4145	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	002019797	MEDICAID	NEVADA
2	E54197	MEDICARE UPIN
3	W-416	OTHER	CALIFORNIA	MEDICARE PTAN
4	E54197	MEDICARE UPIN	NEVADA
5	D0766	MEDICARE ID-TYPE UNSPECIFIED	NEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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