REBECCA L MCCOLLAUM (NPI# 1669658969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669658969 |
| Entity Type | Individual |
| Full Name | REBECCA L MCCOLLAUM |
| Credential | A.P.R.N. |
| Practice Address |
603 W Baseline Rd Ste 200 Mesa AZ 85210-6047 |
| Mailing Address |
3020 E Camelback Rd Ste 301 Phoenix AZ 85016-4418 |
| Practice Telephone | 4804611088 |
| Practice Fax Number | 4804611657 |
| Mailing Telephone | 6022649100 |
| Mailing Fax Number | 6022649101 |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2019-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP3681 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 21321 E Ocotillo Rd Ste 114, Queen Creek, AZ 851425994 | 4804611088 | 4804611657 |
| 1520 S Dobson Rd, Suite 302, Mesa, AZ 852024725 | 4804611088 | 4804611657 |
| Street Address |
603 W BASELINE RD STE 200 |
| City | MESA |
| State | AZ |
| Zip Code | 85210-6047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790746717 | Philip Gregory Foutch | Internal Medicine | 603 W Baseline Rd Ste 200, Mesa, AZ 85210-6047 | 2006-03-29 |
| 1174796999 | Nilay Hasmukh Kavathia | Internal Medicine | 603 W Baseline Rd Ste 200, Mesa, AZ 85210-6047 | 2008-04-12 |
| 1811939747 | Shiv Verma | Internal Medicine | 603 W Baseline Rd Ste 200, Mesa, AZ 85210-6047 | 2006-06-12 |
| 1205898715 | Laurie Lee Peterson | Physician Assistant | 603 W Baseline Rd Ste 200, Mesa, AZ 85210-6047 | 2006-04-03 |
| 1487616892 | Robert L Sawyer Jr. | Internal Medicine | 603 W Baseline Rd Ste 200, Mesa, AZ 85210-6047 | 2006-04-03 |
| 1801858113 | Sumir M. Patel | Internal Medicine | 603 W Baseline Rd Ste 200, Mesa, AZ 85210-6047 | 2006-04-03 |
| 1881655819 | Andrew J. Grade | Internal Medicine | 603 W Baseline Rd Ste 200, Mesa, AZ 85210-6047 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
| 1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
| 1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
| 1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
| 1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
| 1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
| 1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
| 1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
| 1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
| 1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
| Find all providers in zip 85210 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053926410 | Matthew Derrick Miller | Nurse Practitioner | 9354 E Thatcher Cir, Mesa, AZ 85212-8539 | 2020-09-12 |
| 1750995858 | Hayley Madler | Nurse Practitioner | 1061 N Omaha Cir, Mesa, AZ 85205-5023 | 2020-09-04 |
| 1043823800 | Nancy Lynn Mitchell | Nurse Practitioner | 1535 N 26th St, Mesa, AZ 85213-4151 | 2020-08-30 |
| 1003429218 | Krista Ann Clevenger | Nurse Practitioner | 3155 E Southern Ave Ste 203, Mesa, AZ 85204-5521 | 2020-08-26 |
| 1093326290 | Joshua Jackson | Nurse Practitioner | 5432 E Southern Ave Ste 101b, Mesa, AZ 85206-2772 | 2020-08-11 |
| 1790395531 | Kelly C Banonis | Nurse Practitioner | 3322 N Brighton, Mesa, AZ 85207-0997 | 2020-08-06 |
| 1689284911 | Katie Keil | Nurse Practitioner | 1061 N Dobson Rd Ste 107, Mesa, AZ 85201-7576 | 2020-08-02 |
| 1831711670 | Saraswati Hamal | Nurse Practitioner | 4850 S Curie Way, Mesa, AZ 85212-9582 | 2020-05-14 |
| 1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
| 1659992436 | Elizabeth Erb | Nurse Practitioner | 1361 S Alma School Rd, Mesa, AZ 85210-2085 | 2020-05-02 |
| Find all providers in MESA | ||||
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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.