MS. SENETRA SHAYRESSE PUCKETT (NPI# 1265980163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265980163 |
| Entity Type | Individual |
| Full Name | MS. SENETRA SHAYRESSE PUCKETT |
| Practice Address |
59 Leanee Ln Pontiac MI 48340-1651 |
| Mailing Address |
5341 Lynsue Ln Waterford MI 48327-2462 |
| Practice Telephone | 3134551439 |
| Mailing Telephone | 3134551439 |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2016-09-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
59 LEANEE LN |
| City | PONTIAC |
| State | MI |
| Zip Code | 48340-1651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851882799 | Maryan Luay Alkhoory | Dentist | 1620 N Perry St # 1, Pontiac, MI 48340 | 2018-05-26 |
| 1669907689 | Jeffrey D Bryant | Social Worker | 1841 N. Perry St, Pontiac, MI 48340 | 2017-04-27 |
| 1750822748 | Star Dental P.C. | Dentist | 775 Baldwin Rd, Suite C, Pontiac, MI 48340 | 2017-03-10 |
| 1609237965 | Stephanie Stephan | Dentist | 1590 Baldwin Ave, Auburn Hills, MI 48340 | 2016-03-15 |
| 1376908921 | Jump Start LLC Maternal Infant Health Program | Exclusive Provider Organization | 1086 Williamson Cir, Pontiac, MI 48340 | 2015-12-28 |
| 1417339532 | Ana Rodriguez | Point of Service | 612 Peacock Ave, Pontiac, MI 48340 | 2015-06-25 |
| 1104223544 | Tammy Fletcher | Registered Nurse | 1841 N Perry, Pontiac, MI 48340 | 2014-12-01 |
| 1558629238 | Oakland Integrated Healthcare Network | Clinic/Center | 816 Joslyn, Pontiac, MI 48340 | 2012-05-01 |
| 1447583398 | Dial A Doc Physicians PC | Pain Medicine | 28 N Saginaw, Chase Building, Pontiac, MI 48340 | 2009-09-10 |
| 1619199171 | Jann E. Trzeciak | Family Medicine | 1915 N Perrt Street, Pontiac, MI 48340 | 2007-05-03 |
| Find all providers in zip 48340 | ||||
| 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 |
|---|---|---|---|---|
| 1184054207 | Kenneth Jones | Case Manager/Care Coordinator | 545 W Iroquois Rd, Pontiac, MI 48341-2024 | 2013-11-26 |
| 1548477409 | Paul Ira Ferrell II | Case Manager/Care Coordinator | 239 State St, Pontiac, MI 48341-1363 | 2007-05-17 |
| 1063013126 | Erick Post | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2020-11-05 |
| 1083228670 | Lauren Margaret Smith | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2020-09-01 |
| 1669096749 | Jordan Ramsey | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2020-06-03 |
| 1609414663 | Valerie Anne Dankert | Case Manager/Care Coordinator | 1685 Baldwin Ave, Pontiac, MI 48340-1242 | 2019-12-20 |
| 1679111835 | Terrance Maurice Marble | Case Manager/Care Coordinator | 1685 Baldwin Ave, Pontiac, MI 48340-1242 | 2019-12-18 |
| 1417595018 | Deshawnda Smith | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2019-12-13 |
| 1215571898 | Dorene Lajuan Perry | Case Manager/Care Coordinator | 1685 Baldwin Ave, Pontiac, MI 48340-1242 | 2019-11-06 |
| 1790334670 | Sarah Westerman | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2019-09-04 |
| Find all providers in PONTIAC | ||||
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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.