Individual provider Active NPI

David James Collins, MSW, LISW

  • Social Worker
  • Columbus, OH
National Provider Identifier
1003325002
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.1901707 Issued in OH
Practice address
720 E Broad St
Columbus, OH 43215-3988
Phone
(614) 984-6805
NPI assigned
Sep 22, 2017
Last updated
Oct 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I.1901707 OH Primary

Addresses

Primary practice location

720 E Broad St
Columbus, OH 43215-3988

Mailing address

1652 Rhoda Ave
Columbus, OH 43212-1422
Phone (419) 571-6304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260126000260 OH Practitioner - Clinical Social Worker 6608353248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast IncGroup PAC ID 8426014853, 48 clinicians

Practice addresses (Care Compare)

824 Bowtown Rd
Delaware, OH 43015-9661
Phone (740) 695-7795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1901707OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast, Inc CurrentSince Dec 6, 2025 Accepting new patients
Southeast, Inc CurrentSince Dec 6, 2025 Accepting new patients

Locations

16 W Long St
Columbus, OH 43215

720 E Broad St
Columbus, OH 43215
Phone (614) 224-1090

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1003325002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 RHODA AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432121422",
            "telephone_number": "419-571-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153988",
            "telephone_number": "614-984-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "credential": "MSW, LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-22",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1901707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.