CARLYS RACHELLE RICKETTS (NPI# 1265057319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265057319 |
| Entity Type | Individual |
| Full Name | CARLYS RACHELLE RICKETTS |
| Credential | BSW |
| Practice Address |
925 Highway Vv Kennett MO 63857 |
| Mailing Address |
20 S Sprigg St Cape Girardeau MO 63703-6212 |
| Practice Telephone | 5738885925 |
| Mailing Telephone | 5736514177 |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
925 HIGHWAY VV |
| City | KENNETT |
| State | MO |
| Zip Code | 63857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225327083 | Kim Renea Gurley | Case Manager/Care Coordinator | 925 Highway Vv, Kennett, MO 63857 | 2011-04-01 |
| 1033718804 | Jaclyn Stafford | Counselor | 925 Highway Vv, Kennett, MO 63857 | 2020-10-22 |
| 1518571728 | Dana Renee Brunk | Behavior Technician | 925 Highway Vv, Kennett, MO 63857 | 2020-09-04 |
| 1780206185 | Marcus Owens | Specialist | 925 Highway Vv, Kennett, MO 63857 | 2020-05-08 |
| 1154956993 | Shelby Dawn Mcafee | Technician | 925 Highway Vv, Kennett, MO 63857 | 2020-03-11 |
| 1639719214 | Katina Lynn Sadler | Case Manager/Care Coordinator | 925 Highway Vv, Kennett, MO 63857 | 2020-01-10 |
| 1053964478 | Tonya Renee Bridges | Peer Specialist | 925 Highway Vv, Kennett, MO 63857 | 2019-07-24 |
| 1215598404 | Aaron Mark Floyd | Behavior Technician | 925 Highway Vv, Kennett, MO 63857-0071 | 2019-06-27 |
| 1699235960 | Stephanie Martin | Behavior Technician | 925 Highway Vv, Kennett, MO 63857 | 2019-03-22 |
| 1235694779 | Rachael Lee Craig | Technician | 925 Highway Vv, Kennett, MO 63857 | 2019-02-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992278139 | Fancilla Adams | Counselor | 925 State Highway V V, Kennett, MO 63857 | 2019-01-10 |
| 1962994418 | Kiana Alexis Brown | Behavior Technician | 925 Highway W, Kennett, MO 63857 | 2018-05-31 |
| 1568953636 | Doctors Health Group, Inc | Family Medicine | 1312 First Street, Kennett, MO 63857 | 2018-05-24 |
| 1003328873 | Ann Graf | Counselor | 925 Vv, Kennett, MO 63857 | 2017-11-01 |
| 1457872160 | Jessica Luster | Technician, Other | 1109 Jones St., Kennett, MO 63857 | 2017-07-03 |
| 1235669128 | Chandra Celeste Perkins-shannon | Case Manager/Care Coordinator | 925 Hwy V, Kennett, MO 63857 | 2017-06-14 |
| 1467991612 | Sarah Lobdell | Case Manager/Care Coordinator | 925 State Highway Vv, Kennett, MO 63857 | 2017-02-21 |
| 1881132900 | Brandy Rios | Community Health Worker | 935 State Hwy Vv, Kennett, MO 63857 | 2017-02-09 |
| 1295272060 | Johnny Marie Johnson | Case Manager/Care Coordinator | 925 Hwy Vv Family Counseling Center, Kennett, MO 63857 | 2017-01-31 |
| 1043756364 | Heather Bowman | Case Manager/Care Coordinator | 875 Hwy Vv, Kennett, MO 63857 | 2017-01-10 |
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| 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 |
|---|---|---|---|---|
| 1063912657 | Dustin Lynn | Case Manager/Care Coordinator | 1121 Homecrest St, Kennett, MO 63857-1588 | 2018-02-20 |
| 1235669128 | Chandra Celeste Perkins-shannon | Case Manager/Care Coordinator | 925 Hwy V, Kennett, MO 63857 | 2017-06-14 |
| 1467991612 | Sarah Lobdell | Case Manager/Care Coordinator | 925 State Highway Vv, Kennett, MO 63857 | 2017-02-21 |
| 1295272060 | Johnny Marie Johnson | Case Manager/Care Coordinator | 925 Hwy Vv Family Counseling Center, Kennett, MO 63857 | 2017-01-31 |
| 1043756364 | Heather Bowman | Case Manager/Care Coordinator | 875 Hwy Vv, Kennett, MO 63857 | 2017-01-10 |
| 1750823639 | Bridget Moore | Case Manager/Care Coordinator | 875 State Hwy Vv, Kennett, MO 63857 | 2016-11-09 |
| 1598207474 | Melissa Kay Garner | Case Manager/Care Coordinator | 925 State Hwy V V, Kennett, MO 63857 | 2016-11-09 |
| 1093183337 | Hailee Brooks | Case Manager/Care Coordinator | 875 Highway Vv, Kennett, MO 63857 | 2015-09-03 |
| 1275925943 | Matthew Wilbanks | Case Manager/Care Coordinator | 1109 Jones Street, Kennett, MO 63857 | 2015-03-04 |
| 1659785004 | Donna Eakes | Case Manager/Care Coordinator | 925 Highway V. V., Kennett, MO 63857-0071 | 2014-06-13 |
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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.