JACQUELINE ESTELLA KENNEDY (NPI# 1629633920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629633920 |
| Entity Type | Individual |
| Full Name | JACQUELINE ESTELLA KENNEDY |
| Practice Address |
525 E Bonanza Rd Las Vegas NV 89101-3038 |
| Practice Telephone | 7024031444 |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-05-02 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609877653 | Jacqueline F Kennedy | Nurse Practitioner | 181 State Rd, Whately, MA 01093 | 2005-08-02 |
| 1447887468 | Jacqueline Kennedy | Technician, Health Information | 300 W Main St, Medford, OR 97501-2756 | 2020-03-27 |
| 1588108674 | Jacqueline Marie Kennedy | Registered Nurse | 4001 Dutchmans Ln, Louisville, KY 40207-4714 | 2016-12-08 |
| 1528341153 | Jacqueline Roque Kennedy | Counselor | 1034 Oak Grove Rd, Concord, CA 94518-3225 | 2011-09-20 |
| 1336235621 | Jacqueline Kennedy | Psychologist | 930 S Detroit Ave, Toledo, OH 43614-2701 | 2006-10-05 |
| Street Address |
525 E BONANZA RD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89101-3038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386138196 | Vickie Ranae Hopf | Case Manager/Care Coordinator | 525 E Bonanza Rd, Las Vegas, NV 89101-3038 | 2018-06-15 |
| 1649758772 | Zosimo Lugo Santiago | Community/Behavioral Health | 525 E Bonanza Rd, Las Vegas, NV 89101-3038 | 2018-07-31 |
| 1104302363 | Adrienne Mary Babbitt | Case Manager/Care Coordinator | 525 E Bonanza Rd, Las Vegas, NV 89101-3038 | 2018-07-11 |
| 1720573801 | Elegio Bantilan | Community/Behavioral Health | 525 E Bonanza Rd, Las Vegas, NV 89101-3038 | 2018-06-29 |
| 1164917605 | Demarr Wallace Caballero | Community/Behavioral Health | 525 E Bonanza Rd, Las Vegas, NV 89101-3038 | 2018-06-27 |
| 1679068050 | Greg Fleming | Community/Behavioral Health | 525 E Bonanza Rd, Las Vegas, NV 89101-3038 | 2018-06-27 |
| 1609361450 | Christian Taylor Doran | Community/Behavioral Health | 525 E Bonanza Rd, Las Vegas, NV 89101-3038 | 2018-06-25 |
| 1225523095 | Gabrielle Tisdol | Case Manager/Care Coordinator | 525 E Bonanza Rd, Las Vegas, NV 89101-3038 | 2018-06-25 |
| 1235624933 | Lakeisha El Hallaoui | Community/Behavioral Health | 525 E Bonanza Rd, Las Vegas, NV 89101-3038 | 2018-06-25 |
| 1003301086 | Barbara Gonzalez | Community/Behavioral Health | 525 E Bonanza Rd, Las Vegas, NV 89101-3038 | 2018-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671290 | Nadhc At The Acsc, Inc. | Respite Care | 330 N. 13th Street, Las Vegas, NV 89101 | 2019-10-23 |
| 1861033730 | Militza Mares Mikovich | Case Manager/Care Coordinator | 820 S 7th Street Ste A, Las Vegas, NV 89101 | 2019-10-02 |
| 1598311862 | Catalina Ruiz-perez | Technician | 1420 James St., L, Las Vegas, NV 89101 | 2019-08-13 |
| 1053880831 | Samantha Okumura | Specialist/Technologist | 701 E Bridger Ave Ste 150, Las Vegas, NV 89101 | 2018-11-21 |
| 1447752860 | Ratref T Havlin | Technician | 1820 East Bonanza Apt 1, Las Veges, NV 89101 | 2018-03-01 |
| 1396255808 | David Markus Stevens | Technician/Technologist | 930 N. 4th Street, Las Vegas, NV 89101 | 2017-10-10 |
| 1447789888 | Dustin Douglas | Driver | 50 N 21 St #139, Las Vegas, NV 89101 | 2017-06-08 |
| 1013389535 | Direct Scripts Mail, LLC | Pharmacy | 71 N Pecos Road, Suite 104, Las Vegas, NV 89101 | 2015-10-23 |
| 1699169920 | Westcare Nevada Inc | Community/Behavioral Health | 323 N Maryland Parkway, Las Vegas, NV 89101 | 2015-03-25 |
| 1639574262 | Misty Davis | Registered Nurse | 930 N. 4th St., Las Vegas, NV 89101 | 2014-10-24 |
| Find all providers in zip 89101 | ||||
| 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 |
|---|---|---|---|---|
| 1396350773 | Guiselle Maria Alvarez-delarosa | Case Manager/Care Coordinator | 5547 Leaning Oak Ave, Las Vegas, NV 89118-2080 | 2020-09-11 |
| 1477163467 | Chanel M. King | Case Manager/Care Coordinator | 150 Las Vegas Blvd N Unit 2014, Las Vegas, NV 89101-2951 | 2020-08-04 |
| 1912517251 | Jeffrey Hoge | Case Manager/Care Coordinator | 6644 Beacon Rd, Las Vegas, NV 89108-5390 | 2020-08-02 |
| 1992331698 | Angela E Oesterle | Case Manager/Care Coordinator | 8118 Crushed Velvet Pl, Las Vegas, NV 89166-3794 | 2020-03-13 |
| 1336774330 | Taizha Howard | Case Manager/Care Coordinator | 1500 E Tropicana Ave Ste 244, Las Vegas, NV 89119-8325 | 2020-03-10 |
| 1043858863 | Stephanie Marie Sifuentes-smith | Case Manager/Care Coordinator | 2566 Sherwood St Apt 21, Las Vegas, NV 89109-1303 | 2019-12-11 |
| 1932741022 | Deidre Fawn Cleaver | Case Manager/Care Coordinator | 2893 Klinger Cir Apt 2, Las Vegas, NV 89121-1023 | 2019-10-10 |
| 1861033730 | Militza Mares Mikovich | Case Manager/Care Coordinator | 820 S 7th Street Ste A, Las Vegas, NV 89101 | 2019-10-02 |
| 1770132797 | Anna Rose Andrews | Case Manager/Care Coordinator | 3436 Wasatch Cedars St, Las Vegas, NV 89122-3574 | 2019-09-11 |
| 1952954018 | Denise Ratliff | Case Manager/Care Coordinator | 4937 Dunkirk Ave, Las Vegas, NV 89121-7042 | 2019-07-18 |
| Find all providers in LAS VEGAS | ||||
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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.