CECILIO MONDRAGON (NPI# 1669032553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669032553 |
| Entity Type | Individual |
| Full Name | CECILIO MONDRAGON |
| Practice Address |
1127 Second St Lake Village AR 71653-1541 |
| Mailing Address |
790 Roberts Dr Monticello AR 71655-5723 |
| Practice Telephone | 8702653808 |
| Mailing Telephone | 8703672461 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
1127 SECOND ST |
| City | LAKE VILLAGE |
| State | AR |
| Zip Code | 71653-1541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528076114 | Dwana Jo Peoples | Licensed Practical Nurse | 1127 Second St, Lake Village, AR 71653 | 2006-08-03 |
| 1841897576 | Lashaunda Jackson | Case Manager/Care Coordinator | 1127 Second St, Lake Village, AR 71653-1541 | 2020-10-06 |
| 1114572724 | Lekasha Mcclinton | Case Manager/Care Coordinator | 1127 Second St, Lake Village, AR 71653-1541 | 2019-08-09 |
| 1245893254 | Courtney Brown | Case Manager/Care Coordinator | 1127 Second St, Lake Village, AR 71653-1541 | 2019-04-16 |
| 1609166685 | Katrina Lucas | Case Manager/Care Coordinator | 1127 Second St, Lake Village, AR 71653 | 2011-04-12 |
| 1770769218 | Maury Bruton Mccord | Counselor | 1127 Second St, Lake Village, AR 71653-1541 | 2008-01-15 |
| 1013042365 | Luanne Brown | Case Manager/Care Coordinator | 1127 Second St, Lake Village, AR 71653 | 2007-02-23 |
| 1639204985 | Dolly Plummer | Case Manager/Care Coordinator | 1127 Second St, Lake Village, AR 71653 | 2007-02-23 |
| 1790810042 | Mary Howell | Case Manager/Care Coordinator | 1127 Second St, Lake Village, AR 71653 | 2007-02-23 |
| 1962515841 | Misty L Winters | Social Worker | 1127 Second St, Lake Village, AR 71653-1541 | 2006-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500192 | Ashley Brown | Speech-Language Pathologist | 336 Us-82, Lake Village, AR 71653 | 2020-08-26 |
| 1861901985 | Chicot Memorial Medical Center | Clinic/Center | 2729 S. Hwy 65 82, Lake Village, AR 71653 | 2017-09-20 |
| 1326586173 | Mainline Health Systems, Inc | Clinic/Center | 360 A Hwy 82, Lake Village, AR 71653 | 2017-02-01 |
| 1508303124 | Mainline Health Systems, Inc | Clinic/Center | 360 A Highway 82, Lake Village, AR 71653 | 2017-01-20 |
| 1689120263 | Russell Medical Services Pllc | Family Medicine | 5071 Highway 82 E, Lake Village, AR 71653 | 2016-09-01 |
| 1528362035 | Hillman Chiropractic LLC | Chiropractor | 2819 Louis Sessions Dr., Lake Village, AR 71653 | 2010-12-28 |
| 1902113913 | Sheri K Bagwell | Counselor | 1127 Second St., Lake Village, AR 71653 | 2010-09-13 |
| 1205154044 | Arkansas Department of Health | Public Health or Welfare | 1742 Hwy 65 and 82 South, Lake Village, AR 71653 | 2010-05-04 |
| 1114259041 | William Jackson Weaver | General Practice | 1754 Lake Hall Road, Lake Village, AR 71653 | 2010-02-03 |
| 1821246992 | Maurenella Antionette Nelson | Social Worker | 1127 Second Street, Lake Village, AR 71653 | 2008-09-03 |
| Find all providers in zip 71653 | ||||
| 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 |
|---|---|---|---|---|
| 1841897576 | Lashaunda Jackson | Case Manager/Care Coordinator | 1127 Second St, Lake Village, AR 71653-1541 | 2020-10-06 |
| 1114572724 | Lekasha Mcclinton | Case Manager/Care Coordinator | 1127 Second St, Lake Village, AR 71653-1541 | 2019-08-09 |
| 1245893254 | Courtney Brown | Case Manager/Care Coordinator | 1127 Second St, Lake Village, AR 71653-1541 | 2019-04-16 |
| 1598171258 | Chiquita R Courtney | Case Manager/Care Coordinator | 1127 Second Street, Lake Village, AR 71653 | 2014-07-02 |
| 1831516756 | Daniel Shelton Jr. | Case Manager/Care Coordinator | 316 Main St, Lake Village, AR 71653-1942 | 2014-03-28 |
| 1952738494 | Jamie Bell | Case Manager/Care Coordinator | 316 Main St, Lake Village, AR 71653-1942 | 2013-09-30 |
| 1154767754 | Jameenah Williams | Case Manager/Care Coordinator | 316 Main St, Lake Village, AR 71653-1942 | 2013-05-22 |
| 1790121523 | Martha Weatheroy | Case Manager/Care Coordinator | 316 Main St, Lake Village, AR 71653-1942 | 2013-05-20 |
| 1003157553 | Grace Lane Morgan Esters | Case Manager/Care Coordinator | 1127 Second Street, Lake Village, AR 71653 | 2013-03-08 |
| 1588916712 | Melissa Jackson | Case Manager/Care Coordinator | 316 Main St, Lake Village, AR 71653-1942 | 2012-10-11 |
| Find all providers in LAKE VILLAGE | ||||
| City | LAKE VILLAGE |
| Zip Code | 71653 |
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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.