KIMBERLY MCCOLLUM
NPI 1922684364
Nurse Practitioner - Women's Health in San Antonio, TX
About Kimberly Mccollum NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY MCCOLLUM (NPI 1922684364) is an individual women's health provider in San Antonio, Texas, licensed in Texas (818597) and active in the NPI registry since March 2021. She has opted out of Medicare through August 28, 2026 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Kimberly Mccollum has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 28, 2024 through August 28, 2026.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 78258 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN ANTONIO, TX 78258
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 Kimberly Mccollum's NPI number?
The NPI number for Kimberly Mccollum is 1922684364. It was assigned to this individual provider in the NPPES registry on March 23, 2021.
Where is Kimberly Mccollum located?
Kimberly Mccollum practices at 1202 E Sonterra Blvd Ste 102, San Antonio, TX 78258. The listed phone number is (210) 305-5075.
What is Kimberly Mccollum's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.
Is Kimberly Mccollum enrolled in Medicare?
No. Kimberly Mccollum has opted out of Medicare through August 28, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Kimberly Mccollum was last updated on October 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Kimberly Mccollum · NPI 1922684364
Women's Health physician in San Antonio, Texas. Individual provider, active in the CMS NPPES registry since March 23, 2021.
## Identity
- **NPI:** 1922684364 (Entity type: Individual)
- **Enumerated:** March 23, 2021
- **Primary specialty:** Nurse Practitioner - Women's Health · taxonomy 363LW0102X
- **State license:** 818597 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1202 E SONTERRA BLVD STE 102, San Antonio, TX 78258-4238
- **Phone:** (210) 305-5075
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through August 28, 2026); services are provided under private contract
## Record status
- **NPPES last updated:** October 18, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1922684364) · Data from the CMS NPPES public registry.