MS. TANISHA JACKSON (NPI# 1407311509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407311509 |
| Entity Type | Individual |
| Full Name | MS. TANISHA JACKSON |
| Practice Address |
1271 Hogansville Rd Apt 115 Lagrange GA 30241-6667 |
| Practice Telephone | 3346461574 |
| Mailing Telephone | 3346461574 |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-02-04 |
| 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 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6740 James B Rivers Dr, Stone Mountain, GA 300832235 | 4047135896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962065193 | Tanisha Jackson | Case Manager/Care Coordinator | 3100 E 45th St Ste 314, Cleveland, OH 44127-1095 | 2019-04-14 |
| 1750865218 | Tanisha Jackson | Behavior Technician | 180 Grand Ave Ste 225, Oakland, CA 94612-3769 | 2018-09-20 |
| 1700395571 | Tanisha Jackson | Counselor | 9500 Annapolis Rd, A8, Lanham, MD 20706 | 2017-09-25 |
| 1629183777 | Tanisha A Jackson | Dentist | 2860 Michelle, 2nd Floor, Irvine, CA 92606-1009 | 2006-08-20 |
| Street Address |
1271 HOGANSVILLE RD APT 115 |
| City | LAGRANGE |
| State | GA |
| Zip Code | 30241-6667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073994182 | Pathways Center for Behavioral and Developmental Growth | Community/Behavioral Health | 102 Corporate Park Drive East, Lagrange, GA 30241 | 2015-06-15 |
| 1235303686 | Atlas Neck & Back Center | Chiropractor | 309 N. Morgan St., Suite A, Lagrange, GA 30241 | 2008-04-16 |
| 1578756565 | Richard Freeman Simmons | Dentist | 2219 B West Point Rd, Dr Richard F Simmons, Lagrange, GA 30241 | 2007-08-22 |
| 1013071851 | Troup County School District | Local Education Agency (LEA) | 100 North Davis Road, Lagrange, GA 30241 | 2006-12-19 |
| 1851748172 | Medventures Physical Therapy, LLC | Physical Therapist | 1075 Lafayette Parkway, Ste 220, Lagrange, GA 30241 | 2016-05-17 |
| 1154784205 | Med Ventures Mri, LLC | Radiology | 1075 Lafayette Parkway, Ste 120, Lagrange, GA 30241 | 2016-04-05 |
| 1437514965 | Holly Renee Abbott | Counselor | 104 Harwell Ave, Lagrange, GA 30241 | 2015-12-29 |
| 1386780104 | Andre D Feria Md | Internal Medicine | 142 Old Mill Road, Lagrange, GA 30241 | 2007-01-29 |
| 1356354500 | Mohd Khairul Anam | Internal Medicine | 142 Old Mill Road, Lagrange, GA 30241 | 2006-08-15 |
| 1417914052 | Troup County Health Department | Public Health or Welfare | 1220 Hogansville Rd, Department of Family and Childrens Services Health Cent, Lagrange, GA 30241 | 2006-04-27 |
| Find all providers in zip 30241 | ||||
| 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 |
|---|---|---|---|---|
| 1073944500 | Tamara Thomas | Case Manager/Care Coordinator | 4121 Spencer Ct, Lagrange, KY 40031 | 2013-12-10 |
| 1215054390 | Kathy Wood | Case Manager/Care Coordinator | 5105 Macintosh Ave, Lagrange, KY 40031-8911 | 2007-03-23 |
| 1821636846 | Katie Kinsey | Case Manager/Care Coordinator | 122 Gordon Commercial Dr Ste C, Lagrange, GA 30240-5754 | 2019-12-20 |
| 1134767361 | Forrest Johnson | Case Manager/Care Coordinator | 122 Gordon Commercial Dr Ste C, Lagrange, GA 30240-5754 | 2019-12-18 |
| 1760023915 | Mariana Garcia | Case Manager/Care Coordinator | 122 Gordon Commercial Dr Ste C, Lagrange, GA 30240-5754 | 2019-09-30 |
| 1255995593 | Lauren Beaver | Case Manager/Care Coordinator | 122 Gordon Commercial Dr Ste C, Lagrange, GA 30240-5754 | 2019-04-23 |
| 1780144253 | Terri Angela Griffin Jones | Case Manager/Care Coordinator | 122 Gordon Commercial Dr Ste C, Lagrange, GA 30240-5754 | 2019-03-21 |
| 1053816314 | Linda Natasha Rene Jackson | Case Manager/Care Coordinator | 122 Gordon Commercial Dr Ste C, Lagrange, GA 30240-5754 | 2018-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780768 | Covenant Consulting and Practice Management Corp | Case Manager/Care Coordinator | 2900 Weatherstone Cir Se, Conyers, GA 30094-2021 | 2020-11-05 |
| 1194325779 | Stephanie A Jones | Case Manager/Care Coordinator | 517 Fall Creek Ct, Mcdonough, GA 30253-9245 | 2020-10-31 |
| 1952918484 | Andrea Y Daniel | Case Manager/Care Coordinator | 6040 Walters Loop, Columbus, GA 31907-5368 | 2020-09-29 |
| 1730796772 | Abbigail J Boyd | Case Manager/Care Coordinator | 538 Hunterdale Rd, Evans, GA 30809-3630 | 2020-09-24 |
| 1326653890 | Chosen Care, Inc. | Case Manager/Care Coordinator | 5202 Forest Springs Dr, Atlanta, GA 30338-3506 | 2020-09-11 |
| 1689287112 | Nikki Crew | Case Manager/Care Coordinator | 200 Suddeth St, Winterville, GA 30683-1901 | 2020-08-25 |
| 1205448032 | Leona Ramsey Dorsey | Case Manager/Care Coordinator | 19 Shearwater Dr, Fortson, GA 31808-5316 | 2020-08-22 |
| 1467064428 | Kayla M Sims | Case Manager/Care Coordinator | 6475 Calamar Dr, Cumming, GA 30040-7645 | 2020-08-20 |
| 1821600990 | Johnelle Chambers | Case Manager/Care Coordinator | 4045 S Shelby Ln, Douglasville, GA 30135-4141 | 2020-08-20 |
| 1801408919 | April Scott | Case Manager/Care Coordinator | 267 Roberts Rd, Barnesville, GA 30204-3367 | 2020-08-19 |
| Find all providers with the same taxonomy | ||||
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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.