TRACY BRONDYKE (NPI# 1679074793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679074793 |
| Entity Type | Individual |
| Full Name | TRACY BRONDYKE |
| Practice Address |
300 W Louis Glick Hwy Jackson MI 49201-1228 |
| Practice Telephone | 5177829905 |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2018-02-23 |
| Gender Code | F |
| 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 |
300 W LOUIS GLICK HWY |
| City | JACKSON |
| State | MI |
| Zip Code | 49201-1228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639547961 | Lindsey Johns | Counselor | 300 W Louis Glick Hwy, Jackson, MI 49201-1228 | 2015-09-03 |
| 1679944482 | Melissa Tinervia | Counselor | 300 W Louis Glick Hwy, Jackson, MI 49201-1228 | 2015-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| Find all providers in zip 49201 | ||||
| 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 |
|---|---|---|---|---|
| 1023644135 | Leslie Sue Krantz | Case Manager/Care Coordinator | 8431 Oakpoint Dr, Jackson, MI 49201-9229 | 2020-03-20 |
| 1669008405 | Alt Best Practices Bhom2, LLC | Case Manager/Care Coordinator | 81 Crooked Stick Rd, Jackson, NJ 08527-4032 | 2020-03-12 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1336601459 | Richard Daniel Bryant | Case Manager/Care Coordinator | 950 W Monroe St Ste 600a, Jackson, MI 49202-2079 | 2019-04-05 |
| 1013478643 | Makeshia Warden | Case Manager/Care Coordinator | 655 Pine Ln, Jackson, MS 39212-3563 | 2019-03-27 |
| 1053893792 | Allison Brynne Liljestrom | Case Manager/Care Coordinator | 355 Arapahoe Ln, Jackson, WY 83001-8607 | 2018-08-29 |
| 1033691845 | Debra Ann Hathcock | Case Manager/Care Coordinator | 724 W Snow King Ave # 7825, Jackson, WY 83001-8498 | 2018-08-29 |
| 1053809053 | Natasha W Tyler | Case Manager/Care Coordinator | 5615 Brentwood Dr, Jackson, MS 39211-4233 | 2018-04-25 |
| 1245690924 | Darlene Bell | Case Manager/Care Coordinator | 546 Clydes Way, Jackson, GA 30233-1891 | 2016-02-24 |
| 1598134256 | Theodore Weber Shoaf | Case Manager/Care Coordinator | 3405 S Winding Trail Dr, Jackson, WY 83001-9257 | 2015-09-23 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on TRACY BRONDYKE.
| 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.