Active NPI
Camelot Community Care, Inc
- Community/Behavioral Health Agency
- Tallahassee, FL
National Provider Identifier
1629339882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- CAMELOT COMMUNITY CARE, INC
- Practice address
- 1000 W Tharpe St
Suite 7
Tallahassee, FL 32303-5374 - Phone
- (850) 561-8060
- Fax
- (850) 561-1143
- NPI assigned
- Jun 5, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jana Allen
- Title
- Director of Ar
- Phone
- (727) 593-0003
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
1000 W Tharpe St
Suite 7
Tallahassee, FL 32303-5374
Mailing address
4910 Creekside Dr Ste D
Clearwater, FL 33760-4034
Phone (727) 593-0003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070588800 | Medicaid | FL |
National Provider Directory
National Provider Directory- Tax ID family
- Camelot Community Care Inc
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338854400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1629331200000",
"number": "1629339882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4910 CREEKSIDE DR STE D",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337604034",
"telephone_number": "727-593-0003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W THARPE ST",
"address_2": "SUITE 7",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323035374",
"telephone_number": "850-561-8060",
"fax_number": "850-561-1143"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAMELOT COMMUNITY CARE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-06-05",
"last_updated": "2021-08-19",
"certification_date": "2021-08-19",
"status": "A",
"authorized_official_last_name": "ALLEN",
"authorized_official_first_name": "JANA",
"authorized_official_title_or_position": "DIRECTOR OF AR",
"authorized_official_telephone_number": "727-593-0003"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "070588800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.