Individual provider Active NPI

Amy Jean Collins, LCSW

  • Clinical Social Worker
  • Connersville, IN
National Provider Identifier
1851819320
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009503A Issued in IN
Practice address
707 W 3Rd St
Connersville, IN 47331-1577
Phone
(765) 827-1164
Fax
(765) 825-0215
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33008377A IN
Clinical Social Worker 1041C0700X 34009503A IN Primary

Addresses

Primary practice location

707 W 3Rd St
Connersville, IN 47331-1577

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

Other names 1

  • Amy Jean Gero Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20211122003015 IN Practitioner - Clinical Social Worker 3072902519 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33008377AINMDSocial Worker
34009503AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp. CurrentSince Nov 15, 2021 Accepting new patients
Meridian Health Services Corp CurrentSince Nov 15, 2021 Accepting new patients
Meridian Health Services Corp Past Accepting new patients

Locations

707 W 3rd St
Connersville, IN 47331
Phone (765) 827-1164

240 N Tillotson Ave
Muncie, IN 47304

Interoperability endpoints

  • Direct secure messaging: amyj.collins.p1@direct.meridianhs.nextgenshare.com

Organizations & group practices 3

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": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1851819320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W 3RD ST",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473311577",
            "telephone_number": "765-827-1164",
            "fax_number": "765-825-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "AMY",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33008377A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009503A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "GERO",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Connersville, IN

Sources for this page

Verify at the official NPI Registry.