JERRICKA KELLY (NPI# 1710542444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710542444 |
| Entity Type | Individual |
| Full Name | JERRICKA KELLY |
| Credential | B.S. |
| Practice Address |
620 S Laurel St Pine Bluff AR 71601-4859 |
| Practice Telephone | 8705344900 |
| Practice Fax Number | 8705344906 |
| Mailing Telephone | 8705344900 |
| Mailing Fax Number | 8705344906 |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | AR | Other Service Providers |
| Street Address |
620 S LAUREL ST |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71601-4859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154412815 | Rhonda Mattox | Psychiatry & Neurology | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2006-09-27 |
| 1982218830 | Myracle Murrell | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2020-09-08 |
| 1952925919 | The P.a.t. Center | Community/Behavioral Health | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2020-06-04 |
| 1093339137 | Rosalind Wallace | Counselor | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2020-06-04 |
| 1194361824 | Latecia Denay Barnes | Counselor | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-11-18 |
| 1144889874 | Rosemary Campbell-white | Social Worker | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-06-06 |
| 1578127296 | Rae-shem Hawkins | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-04-29 |
| 1437610524 | Tonya Boston | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-03-29 |
| 1518428697 | Curtis Rolfe Iv | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-03-29 |
| 1265990972 | Martin Montgomery | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-03-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162863 | Kb's Adult Health Day Care Center | Clinic/Center | 2911 South Market Street, Pine Bluff, AR 71601 | 2020-10-19 |
| 1184244600 | Chelsea Briggs | Prosthetic/Orthotic Supplier | 601 S Main St Apt 514, Pine Bluff, AR 71601 | 2020-04-24 |
| 1407489081 | Katherine Bolden | Clinic/Center | 2911 East Market Street, Pine Bluff, AR 71601 | 2020-02-21 |
| 1851836829 | Rocky Mountain Holdings, LLC | Ambulance | 613b Hangar Row, Pine Bluff, AR 71601 | 2016-12-30 |
| 1316324494 | Nora Elizabeth Horton | Specialist/Technologist | 2003 University Drive, Suite 2, Pine Bluff, Ar, AR 71601 | 2015-04-28 |
| 1780003665 | Sameer R. Shelat | Internal Medicine | 4125, Rhinehart Road, Pine Bluff, AR 71601 | 2014-04-08 |
| 1700150471 | Community Empowerment Council, Inc. | Social Worker | 5830 Hwy 65 South, Pine Bluff, AR 71601 | 2012-02-28 |
| 1922243807 | The Pine Bluff Group, Pllc | Chiropractor | 2102 S. Olive St., Pine Bluff, AR 71601 | 2008-12-08 |
| 1053571711 | Jefferson Comprehensive Care System Inc | Clinic/Center | 1101 Tennssee, Pine Bluff, AR 71601 | 2008-06-16 |
| 1144404799 | The P.a.t. (people Advocating Transition) Center | Counselor | 620 South Laurel, Pine Bluff, AR 71601 | 2007-12-18 |
| Find all providers in zip 71601 | ||||
| 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 |
|---|---|---|---|---|
| 1407159866 | Joyce Boykins | Case Manager/Care Coordinator | 204 Frankie Ln, Pine Bluff, AR 71602-2699 | 2010-12-07 |
| 1982218830 | Myracle Murrell | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2020-09-08 |
| 1578127296 | Rae-shem Hawkins | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-04-29 |
| 1437610524 | Tonya Boston | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-03-29 |
| 1518428697 | Curtis Rolfe Iv | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-03-29 |
| 1265990972 | Martin Montgomery | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-03-12 |
| 1609331800 | Melissa Battles | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-02-01 |
| 1881158681 | Shandra Freeman | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-01-25 |
| 1073077830 | Joseph Nat Treadwell | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-01-25 |
| 1528522661 | Pamela Jones-wilkins | Case Manager/Care Coordinator | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2019-01-23 |
| Find all providers in PINE BLUFF | ||||
| City | PINE BLUFF |
| Zip Code | 71601 |
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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.