Individual provider Active NPI

Collin O. McCloy, LCSW

  • Clinical Social Worker
  • Gillette, WY
National Provider Identifier
1093070740
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
455 Issued in WY
Practice address
501 S Burma Ave
Gillette, WY 82716-3426
Phone
(307) 688-5000
Fax
(307) 688-5015
NPI assigned
Jul 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 455 WY Primary

Addresses

Primary practice location

501 S Burma Ave
Gillette, WY 82716-3426

Mailing address

501 S Burma Ave
Gillette, WY 82716-3426
Phone (307) 688-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cchwyo@cchwyo.sdhealthlink.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20131212000851 WY Practitioner - Clinical Social Worker 4880821107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell County Hospital DistrictGroup PAC ID 2860392529, 128 clinicians

Practice addresses (Care Compare)

501 S Burma Ave
Gillette, WY 82716-3426
Phone (307) 688-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
455WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell County Hospital District CurrentSince Sep 7, 2013 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District CurrentSince Sep 7, 2013 Accepting new patients
Campbell County Hospital District Current Accepting new patients

Locations

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1093070740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S BURMA AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163426",
            "telephone_number": "307-688-5000",
            "fax_number": "307-688-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S BURMA AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163426",
            "telephone_number": "307-688-5000",
            "fax_number": "307-688-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLOY",
        "first_name": "COLLIN",
        "middle_name": "O.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cchwyo@cchwyo.sdhealthlink.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "501 S Burma Ave",
            "city": "Gillette",
            "state": "WY",
            "country_code": "US",
            "postal_code": "827163426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

Verify at the official NPI Registry.