MITCHELL WALLACE (NPI# 1346859253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346859253 |
| Entity Type | Individual |
| Full Name | MITCHELL WALLACE |
| Practice Address |
4700 Rockside Rd Ste 100 Independence OH 44131-2148 |
| Practice Telephone | 6143391649 |
| Mailing Telephone | 6143391649 |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2020-07-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2910854 | 05 |
| Street Address |
4700 ROCKSIDE RD STE 100 |
| City | INDEPENDENCE |
| State | OH |
| Zip Code | 44131-2148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003113036 | Kelley A Lightner | Licensed Practical Nurse | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2011-02-28 |
| 1972104172 | Danae Ridenour | Licensed Practical Nurse | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-11-04 |
| 1134728645 | Anthony Glass | Case Manager/Care Coordinator | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-10-26 |
| 1861091860 | Kiam Mccutchen | Case Manager/Care Coordinator | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-10-21 |
| 1730787854 | Chanel Connor | Case Manager/Care Coordinator | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-10-12 |
| 1588270805 | Tamara Pratcher | Case Manager/Care Coordinator | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-09-22 |
| 1689283350 | Michelle Brick | Case Manager/Care Coordinator | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-07-28 |
| 1003425372 | Leah Bradford | Licensed Practical Nurse | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-07-23 |
| 1740808955 | Shanika Savage | Case Manager/Care Coordinator | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-07-14 |
| 1750909776 | Nicole Sieg | Case Manager/Care Coordinator | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902457161 | Emilie Hadley | Case Manager/Care Coordinator | 5700 Rockside Rd, Independence, OH 44131 | 2019-09-27 |
| 1316404015 | Denise Ann Shannon | Licensed Practical Nurse | 4700 Rocksde Road, Suite 100, Independence, OH 44131 | 2019-02-28 |
| 1255898433 | Elizabeth Spence | Specialist/Technologist | 806 Tuxedo Ave, Brooklyn Hts, OH 44131 | 2019-02-25 |
| 1407356819 | Stefani Smithburger | Social Worker | 6200 Rockside Woods Blvd, Suite 305, Independence, OH 44131 | 2018-02-13 |
| 1881107092 | Christine M Hernandez | Nurse Practitioner | 2150 Oak Tree Blvd Suite 200, Independence, OH 44131 | 2017-11-09 |
| 1639698368 | Jessica Ann Phillips-donnelly | Social Worker | 5001 Rockside Road, Crown Center II, Independence, OH 44131 | 2017-09-13 |
| 1437692274 | Susan Meghan Davis | Registered Nurse | 925 Keynote Circle Suite #300, Brooklyn Hts, OH 44131 | 2016-11-28 |
| 1629431507 | Patricia Lynn Berger | Counselor | 6200 Rockside Woods Blvd. Suite 305, Independence, OH 44131 | 2016-03-30 |
| 1265810428 | Sarah Krakowiak | Speech-Language Pathologist | 3330 Wynde Tree Drive, Seven Hills, OH 44131 | 2015-05-08 |
| 1255732525 | Michelle Rioux-nivens | Nurse Practitioner | 6150 Oak Tree Boulevard, Suite 200, Independence, OH 44131 | 2014-09-05 |
| Find all providers in zip 44131 | ||||
| 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 |
|---|---|---|---|---|
| 1902457161 | Emilie Hadley | Case Manager/Care Coordinator | 5700 Rockside Rd, Independence, OH 44131 | 2019-09-27 |
| 1194298836 | Dynamic Healthcare Partners LLC | Case Manager/Care Coordinator | 20509 E Blue Mills Rd, Independence, MO 64058-2054 | 2019-01-04 |
| 1831559111 | Susan Wilson | Case Manager/Care Coordinator | 24 Riverside Dr, Independence, VA 24348-3746 | 2016-03-01 |
| 1194003780 | Marsha J. Clark | Case Manager/Care Coordinator | 1830 Pembroke Cres W, Independence, MO 64057-1116 | 2011-07-29 |
| 1568790749 | Charity Faith Morris | Case Manager/Care Coordinator | 314 E Pacific Avenue, Independence, MO 64050 | 2009-11-25 |
| 1033353131 | Terry Lee Horn | Case Manager/Care Coordinator | 700 N Forest Ave, Independence, MO 64050-2320 | 2009-04-21 |
| 1477690121 | Jamie Michelle Kassner | Case Manager/Care Coordinator | 1292 Northgate Dr, Independence, OR 97351-9559 | 2007-01-31 |
| 1578611042 | Kimberly Kay Bess Warth | Case Manager/Care Coordinator | 1897 Bridle Path, Independence, KY 41051-8141 | 2007-01-08 |
| 1134728645 | Anthony Glass | Case Manager/Care Coordinator | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-10-26 |
| 1861091860 | Kiam Mccutchen | Case Manager/Care Coordinator | 4700 Rockside Rd Ste 100, Independence, OH 44131-2148 | 2020-10-21 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 44131 |
Please comment or provide details below to improve the information on MITCHELL WALLACE.
| 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.