CMS-1500 Box 24J / 33a • NPI
1750730966
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LA2200X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health
Box 32 Service Location & ZIP+4
100 LAKE TRAVERSE DR, SISSETON, SD, 57262-7046
✓ 9-Digit EDI 837 ZIP+4 (57262-7046)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1750730966 (BRENDA R. COLLINS, AGPCNP-BC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1750730966 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | BRENDA R. COLLINS, AGPCNP-BC |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health NUCC Code: 363LA2200X (Nurse Practitioner, Adult Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 100 LAKE TRAVERSE DR, SISSETON, SD, 57262-7046 |
| Practice Telephone / Fax | Tel: (605) 698-7606 | Fax: (605) 742-0182 |
| Administrative Mailing Address | 510 4TH ST S, FARGO, ND, 58103-1914 |
| Enumeration & Last Sync | Enumerated: 2016-06-08 | CMS Record Updated: 2018-01-02 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LA2200X)
What Does Taxonomy Code 363LA2200X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LA2200X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BRENDA R. COLLINS, AGPCNP-BC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LA2200X — Nurse Practitioner, Adult HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health | State: SD | License: CP001226 | Primary: Yes (Primary) |
363LA2200X — Nurse Practitioner, Adult HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health | State: ND | License: R32069 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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