LISMAR COLLADO MD
NPI 1063187896
Student in an Organized Health Care Education/Training Program in Jackson, TN
About Lismar Collado Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LISMAR COLLADO MD (NPI 1063187896) is an individual student in an organized health care education/training program in Jackson, Tennessee and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lismar Collado Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JACKSON, TN 38301
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Lismar Collado's NPI number?
The NPI number for Lismar Collado is 1063187896. It was assigned to this individual provider in the NPPES registry on August 13, 2021.
Where is Lismar Collado located?
Lismar Collado practices at 294 Summar Dr, Jackson, TN 38301. The listed phone number is (787) 616-3176.
What is Lismar Collado's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Lismar Collado enrolled in Medicare?
Yes. Lismar Collado is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Lismar Collado was last updated on March 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Lismar Collado, MD · NPI 1063187896
Student in an Organized Health Care Education/Training Program provider in Jackson, Tennessee. Individual provider, active in the CMS NPPES registry since August 13, 2021.
## Identity
- **NPI:** 1063187896 (Entity type: Individual)
- **Enumerated:** August 13, 2021
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 294 SUMMAR DR, Jackson, TN 38301-3915
- **Phone:** (787) 616-3176
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 28, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1063187896) · Data from the CMS NPPES public registry.