Individual provider Active NPI

Edna Cydne Collins, CSWA

  • Clinical Social Worker
  • Medford, OR
National Provider Identifier
1982115978
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
843 E Main St Ste 211
Medford, OR 97504-7137
Phone
(541) 601-1728
NPI assigned
Oct 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

843 E Main St Ste 211
Medford, OR 97504-7137

Mailing address

843 E Main St Ste 211
Medford, OR 97504-7137
Phone (541) 601-1728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20190414000003 OR Practitioner - Clinical Social Worker 8921349259 Practice locations: Medford, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

843 E Main St
Suite 211
Medford, OR 97504-7137
Phone (541) 601-1728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
One of a Kind Therapy LLC Clinical PastSince Jan 19, 2020 Accepting new patients

Organizations & group practices 1

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": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1982115978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 E MAIN ST STE 211",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047137",
            "telephone_number": "541-601-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 E MAIN ST STE 211",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047137",
            "telephone_number": "541-601-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "EDNA",
        "middle_name": "CYDNE",
        "name_prefix": "Ms.",
        "credential": "CSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.