NPIMap

Organization Active NPI

Camelot Community Care, Inc

  • Foster Care Agency
  • Tampa, FL
National Provider Identifier
1639406093
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
Legal business name
CAMELOT COMMUNITY CARE, INC
Practice address
1410 Tech Blvd
Tampa, FL 33619-7865
Phone
(813) 635-9765
Fax
(813) 635-9725
NPI assigned
Nov 5, 2009
Last updated
Jul 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X NU Primary
Community/Behavioral Health Agency 251S00000X MH 7500 FL
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

1410 Tech Blvd
Tampa, FL 33619-7865

Mailing address

4910 Creekside Dr Ste D
Clearwater, FL 33760-4034
Phone (727) 593-0003

Other identifiers 1

IdentifierTypeStateIssuer
070590000MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Camelot Community Care Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

1410 Tech Blvd
Tampa, FL 33619
Phone (813) 635-9735

1412 Tech Blvd
Tampa, FL 33619
Phone (813) 310-4137

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1639406093",
    "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",
            "fax_number": "727-595-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 TECH BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197865",
            "telephone_number": "813-635-9765",
            "fax_number": "813-635-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT COMMUNITY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "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": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MH 7500",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070590000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.