Individual provider Active NPI

Adam Gregory Collard, LMSW

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1962720631
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3515 E Fletcher Ave
Tampa, FL 33613
Phone
(813) 974-2201
NPI assigned
May 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary
Social Worker 104100000X
Addiction (Substance Use Disorder) Counselor 101YA0400X

Addresses

Primary practice location

3515 E Fletcher Ave
Tampa, FL 33613

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other practice location 1

551 Courthouse Dr
Suite 5
Charlotte, MI 48813-1054
Phone (517) 543-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20181106000998 FL Practitioner - Clinical Social Worker 5890048078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4202 E Fowler Ave
Tampa, FL 33620-6750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc Current Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Jul 31, 2018 Accepting new patients
University Medical Service Association Inc CurrentSince Jul 31, 2018 Accepting new patients
Community Mental Health Authority of Clinton Eaton Ingham Counties PastSince Feb 28, 2017 Accepting new patients

Locations

3515 E Fletcher Ave
Tampa, FL 33613
Phone (813) 974-2748

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

Interoperability endpoints

  • Direct secure messaging: acollard149172@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1962720631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33613",
            "telephone_number": "813-974-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "551 Courthouse Dr",
            "address_2": "Suite 5",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "MI",
            "postal_code": "488131054",
            "country_code": "US",
            "telephone_number": "517-543-5100",
            "fax_number": "517-543-1811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLARD",
        "first_name": "ADAM",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-05",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.