Active NPI
John Wesley Collins III, B.S
- Social Worker
- Idaho Falls, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1740 E 17TH St Ste C
Idaho Falls, ID 83404-6375 - Phone
- (208) 524-1278
- NPI assigned
- Aug 11, 2009
- Last updated
- Aug 11, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
1740 E 17TH St Ste C
Idaho Falls, ID 83404-6375
Mailing address
905 Stanger Ave
Idaho Falls, ID 83404-5521
Phone (208) 757-2994
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2705 E 17TH St
Ammon, ID 83406-6601
Phone 2083467500506
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pearl Health Clinic | Current | Accepting new patients |
Locations
2705 E 17th St
Ammon, ID 83406
Phone (208) 346-7501
725 S Woodruff Ave
Ste 101
Idaho Falls, ID 83401
500 S 11th Ave
Ste 203
Pocatello, ID 83201
Phone (208) 232-5902
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Ammon, ID
- NPI 1447426465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249948800000",
"number": "1992937874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 STANGER AVE",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834045521",
"telephone_number": "208-757-2994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 E 17TH ST STE C",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834046375",
"telephone_number": "208-524-1278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "JOHN",
"middle_name": "WESLEY",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "B.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-11",
"last_updated": "2009-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.