Jamie Colvin
Individual provider Active NPI Clinical Social Worker · Madison, WI
NPI 1902254659 · NPPES record last updated Jan 19, 2021
Key facts
- NPI
- 1902254659
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 8658 (WI)
- Practice address
- 2202 S Park St
Madison, WI 53713-1916 - Phone
- (608) 443-5480
- NPI assigned
- Jun 2, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Access Community Health Centers Inc
Practice addresses (Care Compare)
1102 S Park St
Madison, WI 53715-1708
Phone (608) 263-3111
2202 S Park St
Madison, WI 53713-1916
Phone (608) 443-5480
3434 E Washington Ave
Madison, WI 53704-4155
Phone (608) 443-5480
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171004000000 | WI | Practitioner - Clinical Social Worker | 4789959644 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 128942121 | WI | MD | Social Worker |
| 8658 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Community Health Centers, Inc. | Current |
Accepting new patients | |
| Access Community Health Centers, Inc. | Current |
Accepting new patients |
Locations
2901 W Beltline Hwy
Ste 120
Madison, WI 53713
Phone (608) 443-5500
2202 S Park St
Madison, WI 53713
Phone (608) 443-5480
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 128942121 | WI | |
| Clinical Social Worker | 1041C0700X | 8658 | WI | Yes |
Addresses
Primary practice location
2202 S Park St
Madison, WI 53713-1916
Mailing address
2713 Waunona Way
Madison, WI 53713-1543
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jcolvin847108@direct.uwhealth.org |
Other providers in Madison, WI
- John P Colmenares
- Vincent Matthew Colon IV
- Kelly J Coloso
- Kara Colten
- Jake Ryan Colvin
- Chad Glenn Colwell
- Shannon John Colwin
- Daniel James Comeaux
- Richard E Comello
- Jessica Comerford
All providers in Madison, WI · Clinical Social Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.