COLLABORATIVE ADULT PSYCHIATRY LLC.
COLLABORATIVE ADULT PSYCHIATRY LLC. is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1003614645, based in Jacksonville, FL. It is classified under Psychiatric/Mental Health Nurse Practitioner.
Getting there
Here is what surrounds this office in Jacksonville, based on OpenStreetMap data collected Sep 5, 2026. Parking is available about 375 ft away.
Getting here and what is nearby
Parking 296 ft ~2 min
Parking 312 ft ~2 min
Parking 375 ft ~2 min
Restaurant Don Juan's 373 ft ~2 min
Restaurant Clara's Tidbits 657 ft ~3 min
Restaurant Dolce's Pizza 723 ft ~3 min
Gas station GATE Gas Station 0.28 mi ~6 min
Gas station Gate Gas 0.29 mi ~6 min
Convenience Daily's 0.32 mi ~7 min
Gas station Shell 0.32 mi ~7 min
12227 San Jose Boulevard, Jacksonville 32223
Distances are straight‑line estimates — walking routes may be longer. Hours and phone numbers can change; call ahead to confirm.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 8729504899
- Enrollment ID
- O20250501001610
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Psychiatric/Mental Health covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363LP0808X
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1003614645 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Mar 7, 2025 |
| Last updated | Mar 7, 2025 |
| Status | Active |
| Practice address |
12412 SAN JOSE BLVD STE 304D Jacksonville, FL 32223 (904) 706-1551 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 0 | 3 | 6 | 1 | 4 | 6 | 4 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 0 | 3 | 3 | 1 | 8 | 6 | 8 |
Sum = 55 · next multiple of 10 = 60 · check digit = 5 · actual last digit = 5
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.