BRANDON K CLARK (NPI# 1063988939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063988939 |
| Entity Type | Individual |
| Full Name | BRANDON K CLARK |
| Practice Address |
103 4th St Jonesboro LA 71251-3346 |
| Mailing Address |
2380 Martin Luther King Jr Ave Apt 7 Grambling LA 71245-2113 |
| Practice Telephone | 3182591500 |
| Mailing Telephone | 3186074302 |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2018-10-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528522083 | Brandon Clark | Registered Nurse | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2019-01-29 |
| 1972054393 | Brandon Clark | Counselor | 8930 Stanford Blvd, Suite M 100, Columbia, MD 21045-5805 | 2016-10-20 |
| 1932561115 | Brandon W. Clark | Social Worker | 1203 Idaho St, Lewiston, ID 83501-1940 | 2016-03-25 |
| 1871872416 | Brandon C Clark | Counselor | 500 Fairway Dr, Deerfield Beach, FL 33441-1814 | 2011-08-14 |
| 1174844138 | Brandon Clark | Orthopaedic Surgery | 107 E Oak Ave, Flagstaff, AZ 86001 | 2010-06-14 |
| 1528256955 | Brandon Clark | Counselor | 3995 Marcola Rd, Springfield, OR 97477-7948 | 2007-10-10 |
| Street Address |
103 4TH ST |
| City | JONESBORO |
| State | LA |
| Zip Code | 71251-3346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528398799 | Alesia Fortune | Behavioral Analyst | 103 4th St, Jonesboro, LA 71251 | 2010-01-11 |
| 1104465244 | Lakayci Markia Cooks | Case Manager/Care Coordinator | 103 4th St, Jonesboro, LA 71251-3346 | 2020-01-06 |
| 1811556004 | Latoya Holston | Case Manager/Care Coordinator | 103 4th St, Jonesboro, LA 71251-3346 | 2019-06-11 |
| 1417516287 | A'drian Jordan | Case Manager/Care Coordinator | 103 4th St, Jonesboro, LA 71251-3346 | 2019-06-06 |
| 1316409238 | Leonard Booker | Case Manager/Care Coordinator | 103 4th St, Jonesboro, LA 71251-3346 | 2019-04-01 |
| 1750876207 | Kendra Hall | Case Manager/Care Coordinator | 103 4th St, Jonesboro, LA 71251-3346 | 2018-06-27 |
| 1528559135 | Jarmichael Nelson | Case Manager/Care Coordinator | 103 4th St, Jonesboro, LA 71251-3346 | 2018-05-21 |
| 1174033492 | Dorrella Hull | Counselor | 103 4th St, Jonesboro, LA 71251-3346 | 2017-10-02 |
| 1245749530 | Evette Gipson | Behavioral Analyst | 103 4th St, Jonesboro, LA 71251 | 2017-09-29 |
| 1801305222 | Juanita Bobo | Counselor | 103 4th St, Jonesboro, LA 71251-3346 | 2017-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962985432 | Jonathan Rogers | Non-emergency Medical Transport (VAN) | 131 Eden Circle, Jonesboro, LA 71251 | 2018-09-11 |
| 1891273546 | Charlotte Amos | Case Manager/Care Coordinator | 248 Collin Rd, Jonesboro, LA 71251 | 2018-08-04 |
| 1528429578 | Lisa Hammock | Counselor | 124 Hudson Ave, Jonesboro, LA 71251 | 2016-03-17 |
| 1851752661 | Monique Burks | Behavioral Analyst | 103 4th Street, Stepping Stones, Jonesboro, LA 71251 | 2016-03-08 |
| 1184080046 | Deon Jones | Counselor | 206 Hudson Ave, Jonesboro, LA 71251 | 2016-01-07 |
| 1942672894 | Timothy Stewart | Behavioral Analyst | 201 Forest Dr, Jonesboro, LA 71251 | 2015-10-29 |
| 1871964148 | Stacey Harrell | Social Worker | 305 Cobb Dr, Jonesboro, LA 71251 | 2015-10-13 |
| 1184848756 | Mayfield Chiropractic Jonesboro, LLC | Chiropractor | 520 S. Polk St., Jonesboro, LA 71251 | 2007-04-12 |
| 1093793408 | Jackson Parish Hospital | General Acute Care Hospital | 165 Beech Springs Rd, Jonesboro, LA 71251 | 2006-01-05 |
| 1134697097 | Tyler Anderson | Case Manager/Care Coordinator | 525 Alexander St, Jonesboro, LA 71251 | 2018-11-08 |
| Find all providers in zip 71251 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1619516051 | Kyjione King | Case Manager/Care Coordinator | 721 S Gee St Ste A, Jonesboro, AR 72401-3308 | 2020-01-02 |
| 1487205845 | Jamie Lynn Echeverria | Case Manager/Care Coordinator | 837 Willett Road, Jonesboro, AR 72401-7240 | 2019-09-26 |
| 1043877608 | Tristan Kole Meador | Case Manager/Care Coordinator | 1905 Race St, Jonesboro, AR 72401-7212 | 2019-05-20 |
| 1972088425 | Kenan Shell | Case Manager/Care Coordinator | 4009 Clay Dr, Jonesboro, AR 72404-8543 | 2018-10-01 |
| 1710462759 | Kelly Seltzer | Case Manager/Care Coordinator | 320 Monterey Cir, Jonesboro, GA 30236-8242 | 2018-09-26 |
| 1891273546 | Charlotte Amos | Case Manager/Care Coordinator | 248 Collin Rd, Jonesboro, LA 71251 | 2018-08-04 |
| 1407376486 | Angelijica Ivey | Case Manager/Care Coordinator | 8322 Marlborough Dr, Jonesboro, GA 30238-2943 | 2017-06-21 |
| 1275071607 | Coral Nicole Burke | Case Manager/Care Coordinator | 1806 Kathleen St, Apt. B, Jonesboro, AR 72401-9104 | 2017-02-06 |
| 1356889794 | Juan Sheppard | Case Manager/Care Coordinator | 3309 Kingsbury St, Jonesboro, AR 72401-5412 | 2017-02-06 |
| Find all providers in JONESBORO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.