Individual provider Active NPI

Amanda Colliver

  • Clinical Social Worker
  • Medina, OH
National Provider Identifier
1487355376
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1801162-SUPV Issued in OH
Practice address
3567 Reserve Commons Dr Ste 100
Medina, OH 44256-5344
Phone
(330) 664-9250
NPI assigned
Mar 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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 I.1801162-SUPV OH Primary

Addresses

Primary practice location

3567 Reserve Commons Dr Ste 100
Medina, OH 44256-5344

Mailing address

3567 Reserve Commons Dr Ste 100
Medina, OH 44256-5344
Phone (330) 664-9250

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
I20230330002011 OH Practitioner - Clinical Social Worker 1254706443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alcove Ventures LLCGroup PAC ID 1456669605, 50 clinicians

Practice addresses (Care Compare)

1471 Wills Creek Valley Dr
Cambridge, OH 43725-8620
Phone (440) 333-5401

165 N Stygler Rd
Gahanna, OH 43230-2436
Phone (440) 333-5401

1800 Riverside Dr
Columbus, OH 43212-1855
Phone (440) 333-5401

2600 E Main St
Columbus, OH 43209-2446
Phone (440) 333-5401

3567 Reserve Commons Dr
Suite 100
Medina, OH 44256-5344
Phone (330) 536-3746

4615 Library Way
Hilliard, OH 43026-3505
Phone (330) 536-3746

4959 Medfield Way
Columbus, OH 43228-1653
Phone (440) 333-5401

717 Neil Ave
Columbus, OH 43215-1609
Phone (440) 333-5401

Merit-based Incentive Payment System (MIPS)

Final score
98.06 of 100Reported as group
Quality
90.22
Promoting interoperability
100
Improvement activities
40
Cost
69.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1801162-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alcove Ventures LLC CurrentSince Mar 20, 2023 Accepting new patients

Locations

3567 Reserve Commons Dr
Ste 100
Medina, OH 44256
Phone (330) 664-9250

3593 Medina Rd
Medina, OH 44256
Phone (330) 664-9250

Organizations & group practices 1

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": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1487355376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3567 RESERVE COMMONS DR STE 100",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565344",
            "telephone_number": "330-664-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3567 RESERVE COMMONS DR STE 100",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565344",
            "telephone_number": "330-664-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIVER",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1801162-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

Verify at the official NPI Registry.