Jonathan McCollum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6020 Issued in TN

Practice address

210 Simmons St
Maryville, TN 37801-4750

Phone

(865) 970-9800

Fax

(865) 374-7129

NPI assigned

Sep 17, 2007

Last updated

Jun 11, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

River Region Psychiatry Associates, LLCGroup PAC ID 1254491012, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• FL HMO
• MS PPO
• AL HMO D-SNP
• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• MS PPO C-SNP
• FL HMO D-SNP
• KY PPO
• TN PPO C-SNP
• MS PPO D-SNP
• AL HMO
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• KY PPO C-SNP
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• TN PPO
• FL HMO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• River Region Psychiatry Associates LLC

  dba Ally Psychiatry

  • Psychiatry Physician
  • Montgomery, AL
  • NPI 1386891497

  GA, TN

  Medicare reassignment Care Compare group NPD
• Parkwest Medical Center

  dba Peninsula Outpatient Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Maryville, TN
  • NPI 1699757609
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1003002734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 DOWELL SPRINGS BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092441",
            "telephone_number": "865-374-7123",
            "fax_number": "865-374-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SIMMONS ST",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014750",
            "telephone_number": "865-970-9800",
            "fax_number": "865-374-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "JONATHAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-17",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew J McCarty, MD
• Jaime Lee McClellan, APRN
• Jennifer McClements
• Chad Andrew McClure, DNP
• Leighanna Brooke McClure, R.N.
• Timothy P McConnell, DDS
• Karissa McCoy
• Atlanta Gayle Russell McCravey, FNP-BC
• Amanda Marianne McEntee, LPC
• Alicia McFalls

• Clinical Social Worker in Maryville, TN
• Providers in Maryville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.