Individual provider Active NPI

Robert Aloysius Crimmins, LCSW

  • Clinical Social Worker
  • Bunnell, FL
National Provider Identifier
1477552297
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW3326 Issued in FL
Practice address
301 Justice LN
Bunnell, FL 32110-4487
Phone
(386) 236-3265
NPI assigned
Jul 14, 2005
Last updated
Nov 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 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 SW3326 FL Primary

Addresses

Primary practice location

301 Justice LN
Bunnell, FL 32110-4487

Mailing address

20 Sandpiper LN
Ormond Beach, FL 32174-4264
Phone (386) 676-1745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220203001508 FL Practitioner - Clinical Social Worker 1355734997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sma Healthcare IncGroup PAC ID 0244226363, 39 clinicians

Practice addresses (Care Compare)

105 W Calvin St
Deland, FL 32720-7403
Phone (800) 539-4228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW3326FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sma Healthcare, Inc CurrentSince Dec 1, 2021 Accepting new patients
Sma Healthcare Inc Current Accepting new patients
Sma Healthcare Inc CurrentSince Dec 1, 2021 Accepting new patients
Yorkshire Mental Health Enterprises PA Clinical Past Accepting new patients
Sma Healthcare Inc PastSince Jul 28, 2019 Accepting new patients
Sma Healthcare Inc Past Accepting new patients

Locations

301 Justice Ln
Bunnell, FL 32110
Phone (386) 236-1726

1150 Red John Dr
Daytona Beach, FL 32124
Phone (386) 236-3183

1220 Willis Ave
Daytona Beach, FL 32114
Phone (386) 236-3200

150 Magnolia Ave
Daytona Beach, FL 32114
Phone (386) 236-3215

225 Fentress Blvd
Ste A
Daytona Beach, FL 32114
Phone (386) 236-3221

3875 Tiger Bay Rd
Daytona Beach, FL 32124
Phone (386) 947-1328

702 S Ridgewood Ave
Daytona Beach, FL 32114
Phone (386) 254-1262

356 Englenook Dr
Ste 142
Debary, FL 32713

105 W Calvin St
Deland, FL 32720
Phone (386) 236-3290

1251 N Stone St
Deland, FL 32720
Phone (386) 469-1544

330 Kay Larkin Dr
Palatka, FL 32177
Phone (386) 329-3780

1955 US Highway 1 S
Ste C2
Saint Augustine, FL 32086
Phone (904) 209-6001

1880 San Sebastian Vw
Ste 4201
St Augustine, FL 32084

Interoperability endpoints

  • Direct secure messaging: robert.crimmins.p1@direct.smahealthcare.nextgenshare.com

Organizations & group practices 6

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1477552297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SANDPIPER LN",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321744264",
            "telephone_number": "386-676-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 JUSTICE LN",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321104487",
            "telephone_number": "386-236-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIMMINS",
        "first_name": "ROBERT",
        "middle_name": "ALOYSIUS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW3326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bunnell, FL

Sources for this page

Verify at the official NPI Registry.