ERICA M SHACKELFORD (NPI# 1649577883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649577883 |
| Entity Type | Individual |
| Full Name | ERICA M SHACKELFORD |
| Credential | MHPP |
| Practice Address |
2126 N 1st. Street Suite F Jacksonville AR 72076 |
| Mailing Address |
1815 Pleasant Grove Road Jonesboro AR 72404 |
| Practice Telephone | 5019825000 |
| Practice Fax Number | 5019825007 |
| Mailing Telephone | 8709336886 |
| Mailing Fax Number | 8709339395 |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2017-02-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902375694 | Erica Shackelford | Nurse Practitioner | 540 Fort Evans Rd Ste 204, Leesburg, VA 20176-3379 | 2018-11-26 |
| Street Address |
2126 N 1ST. STREET SUITE F |
| City | JACKSONVILLE |
| State | AR |
| Zip Code | 72076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598396046 | Jennifer Michelle Price | Licensed Practical Nurse | 2400 West Main, Jacksonville, AR 72076 | 2020-02-03 |
| 1912464009 | Stat Home Health - Cenark LLC | Home Health | 1410 Braden Street, Jacksonville, AR 72076 | 2019-02-25 |
| 1649797671 | Caring Hearts Counseling, LLC | Case Management | 111 Marble Drive, Jacksonville, AR 72076 | 2017-08-30 |
| 1376071340 | Anne Elizabeth Houtchens | Speech-Language Pathologist | 2701 Tp White Drive, Jacksonville, AR 72076 | 2017-06-02 |
| 1881140648 | Jacksonville North Pulaski School District | Local Education Agency (LEA) | 1414 West Main, Jacksonville, AR 72076 | 2016-08-31 |
| 1134599772 | Jeremiah Melson Fleeman | Occupational Therapist | 2701 Tpwhite Drive, Jacksonville, AR 72076 | 2015-09-25 |
| 1821424565 | Kasey Michele Leeson | Social Worker | 2520 W. Main St., Jacksonville, AR 72076 | 2013-09-25 |
| 1407104052 | Cesalie Deonne Wallace | Nurse Practitioner | 3000 North First Street, Jacksonville, AR 72076 | 2012-08-29 |
| 1952660995 | Joshua Aaron Hill | Case Manager/Care Coordinator | 2126 N. 1st St Suite F, Jacksonville, AR 72076 | 2012-05-11 |
| 1396023156 | Syreeta Tucker | Case Manager/Care Coordinator | 1109 Burman, Jacksonville, AR 72076 | 2011-07-28 |
| Find all providers in zip 72076 | ||||
| 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 |
|---|---|---|---|---|
| 1386256014 | Jessica Marie Hazelip | Case Manager/Care Coordinator | 2126 N 1st St, Jacksonville, AR 72076-2870 | 2020-08-24 |
| 1235757493 | Terena D Hoover | Case Manager/Care Coordinator | 731 Duval Station Rd Ste 107-257, Jacksonville, FL 32218-0800 | 2020-07-13 |
| 1255955514 | Shan Lowry | Case Manager/Care Coordinator | 1007 Tortoise Way, Jacksonville, FL 32218-7635 | 2020-06-02 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1780228510 | Equeisha Jones | Case Manager/Care Coordinator | 1006 N Liberty St, Jacksonville, FL 32206-5631 | 2019-11-05 |
| 1447801865 | Sydney Broussard | Case Manager/Care Coordinator | 3544 Saint Johns Bluff Rd S Apt 922, Jacksonville, FL 32224-2674 | 2019-09-26 |
| 1558928291 | Sherri Mason | Case Manager/Care Coordinator | 8005 Renault Dr, Jacksonville, FL 32244-1325 | 2019-05-28 |
| 1760951438 | Tashera Muray Nielsen | Case Manager/Care Coordinator | 7925 Merrill Rd Apt 2809, Jacksonville, FL 32277-6544 | 2018-11-24 |
| 1588147110 | Patricia Ceasar Pitts | Case Manager/Care Coordinator | 13764 Chipperfield Ln, Jacksonville, FL 32226-5832 | 2018-09-10 |
| 1447738307 | Pamela R Wright | Case Manager/Care Coordinator | 10955 Sterling Silver Ct, Jacksonville, FL 32218-7342 | 2018-08-02 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 72076 |
Please comment or provide details below to improve the information on ERICA M SHACKELFORD.
| 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.