MR. DARRELL BERNARD COLLIERS (NPI# 1588829048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588829048 |
| Entity Type | Individual |
| Full Name | MR. DARRELL BERNARD COLLIERS |
| Credential | CFA PA |
| Practice Address |
15200 Community Rd Gulfport MS 39523 |
| Mailing Address |
230 Audubon Drive Mandeville LA 70471 |
| Practice Telephone | 2285757000 |
| Mailing Telephone | 9858451501 |
| Mailing Fax Number | 9858451601 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
616147 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NATL 1ST ASSIST CORP | 616147 | 01 |
| Street Address |
15200 COMMUNITY RD |
| City | GULFPORT |
| State | MS |
| Zip Code | 39523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043288541 | Glen Michael Cavalier | Nurse Anesthetist, Certified Registered | 15200 Community Rd, Gulfport, MS 39503-3085 | 2006-03-09 |
| 1023629847 | Ariel Nicole Fore | Nurse Practitioner | 15200 Community Rd, Gulfport, MS 39503-3085 | 2020-08-14 |
| 1801414115 | Singing River Gulfport | Psychiatric Unit | 15200 Community Rd, Gulfport, MS 39503-3085 | 2020-07-13 |
| 1639797913 | Singing River Gulfport | General Acute Care Hospital | 15200 Community Rd, Gulfport, MS 39503-3085 | 2020-07-13 |
| 1972071611 | Jessica Irene Strunk | Nurse Practitioner | 15200 Community Rd, Gulfport, MS 39503-3085 | 2018-11-12 |
| 1326558388 | Jeremy Lynn Remillard | Nurse Practitioner | 15200 Community Rd, Gulfport, MS 39503-3085 | 2017-10-04 |
| 1285155614 | Truong Vu Nguyen | Nurse Practitioner | 15200 Community Rd, Gulfport, MS 39503-3085 | 2017-07-06 |
| 1083158307 | Wesley Armstrong | Physician Assistant | 15200 Community Rd, Gulfport, MS 39503-3085 | 2016-12-05 |
| 1649647256 | Jennifer Duncan | Nurse Practitioner | 15200 Community Rd, Gulfport, MS 39503-3085 | 2015-08-31 |
| 1497131791 | Keystone Hospitalist Services of Gulfport Inc | Hospitalist | 15200 Community Rd, Gulfport, MS 39503-3085 | 2015-08-10 |
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| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487027504 | Advanced Surgical Assistants LLC | Physician Assistant | 1924 30th Ave Ste A, Gulfport, MS 39501-4534 | 2015-11-11 |
| 1326478744 | William Bishop | Physician Assistant | 11476 Savannah Pl, Gulfport, MS 39503-1109 | 2013-11-21 |
| 1376840173 | Christopher Lawrence Sweebe | Physician Assistant | 741 Beaus Landing Dr, Gulfport, MS 39507-4347 | 2011-02-15 |
| 1528275633 | Tina M Mcginty | Physician Assistant | 250 Church Ave, Gulfport, MS 39507-1255 | 2007-05-17 |
| 1639736432 | Johnathon R Herron | Physician Assistant | 4500 13th St, Gulfport, MS 39501-2515 | 2019-05-28 |
| 1245613694 | John Miyakawa | Physician Assistant | 12337 Ashley Dr, Suite F, Gulfport, MS 39503-2753 | 2015-07-02 |
| 1366864811 | Latricia Rochelle Allen | Physician Assistant | 741 Beaus Landing Dr, Gulfport, MS 39507-4347 | 2014-01-16 |
| 1851688618 | Precision Surgical Resources | Physician Assistant | 741 Beaus Landing Dr, Gulfport, MS 39507-4347 | 2011-06-30 |
| 1033208889 | Randall W Chang | Physician Assistant | 1340 Broad Ave, Suite 420, Gulfport, MS 39501-2404 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477091742 | Madeline Grace Daniels | Physician Assistant | 501 Marshall St Ste 400, Jackson, MS 39202-1687 | 2017-02-07 |
| 1114392172 | Robin Rae Hoffeld | Physician Assistant | 11401 Wedgewood Ln, Ocean Springs, MS 39564-7910 | 2015-12-02 |
| 1063889509 | Julie Dianne Sullivan | Physician Assistant | 216 Linda Dr, Ocean Springs, MS 39564-4114 | 2015-09-01 |
| 1922190271 | Robert L. Gillum Jr. | Physician Assistant | 6099 Adaughtery Rd, Suite A, Long Beach, MS 39560 | 2006-09-28 |
| 1841249489 | Bradley Martin | Physician Assistant | 1014 Biglane Drive, Brookhaven, MS 39601 | 2006-05-10 |
| 1144293655 | David Bradley Robbins | Physician Assistant | 206 Oxford Rd, New Albany, MS 38652-3115 | 2006-02-07 |
| 1801877022 | Benjamin P Watts | Physician Assistant | 3615 Hospital St, Pascagoula, MS 39581-4112 | 2005-11-07 |
| 1972133353 | Justin Bryant Schopp | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-24 |
| 1275163727 | Kaitlin Lehto | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4684 | 2020-01-23 |
| 1154951739 | Hailey Daniels Kelly | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.