SHELBY J CHAVIS (NPI# 1750817078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750817078 |
| Entity Type | Individual |
| Full Name | SHELBY J CHAVIS |
| Credential | MA |
| Practice Address |
2018 Talley Rd Leesburg FL 34748 |
| Mailing Address |
Po Box 491000 Leesburg FL 34749-1000 |
| Practice Telephone | 3523157420 |
| Practice Fax Number | 3523157587 |
| Mailing Telephone | 3523157537 |
| Mailing Fax Number | 3523157587 |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2018-07-03 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 021220700 | 05 |
| Street Address |
2018 TALLEY RD |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629033493 | Brad Broyles | Psychiatry & Neurology | 2018 Talley Rd, Leesburg, FL 34748-3426 | 2006-04-17 |
| 1174157994 | Hope Harvey | Counselor | 2018 Talley Rd, Leesburg, FL 34748-3426 | 2020-03-02 |
| 1891347548 | Terri Lynn Mcdonald | Social Worker | 2018 Talley Rd, Leesburg, FL 34748-3426 | 2019-07-12 |
| 1487145777 | Jenenne R Valentino-bottaro | Counselor | 2018 Talley Rd, Leesburg, FL 34748 | 2018-05-23 |
| 1154700680 | Jessica Cougler | Counselor | 2018 Talley Rd, Leesburg, FL 34748-3426 | 2015-05-29 |
| 1063801546 | Patricia Ming | Case Manager/Care Coordinator | 2018 Talley Rd, Leesburg, FL 34748 | 2015-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| 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 |
|---|---|---|---|---|
| 1396239786 | Marisa R Benson | Case Manager/Care Coordinator | 600 Market St Ste 116, Leesburg, FL 34748-5143 | 2018-06-19 |
| 1760974869 | Debbie D Wheeler | Case Manager/Care Coordinator | 227 Roanoke Dr Se, Leesburg, VA 20175-4007 | 2018-06-04 |
| 1568019792 | Catherine Heflin | Case Manager/Care Coordinator | 215 N 3rd St, Leesburg, FL 34748-5105 | 2019-08-22 |
| 1003306408 | Katherine Campbell | Case Manager/Care Coordinator | 102 Heritage Way Ne Ste 302, Leesburg, VA 20176-4544 | 2018-05-11 |
| 1023506508 | William Gatewood | Case Manager/Care Coordinator | 102 Heritage Way Ne Ste 302, Leesburg, VA 20176-4544 | 2018-04-30 |
| 1316484561 | Jason Perry | Case Manager/Care Coordinator | 102 Heritage Way Ne Ste 302, Leesburg, VA 20176-4544 | 2017-01-26 |
| 1417302241 | John Mercandetti | Case Manager/Care Coordinator | 102 Heritage Way Ne Ste 302, Leesburg, VA 20176-4544 | 2016-04-29 |
| 1790144814 | Mike Bernal | Case Manager/Care Coordinator | 102 Heritage Way Ne Ste 302, Leesburg, VA 20176-4544 | 2016-02-17 |
| 1821455460 | Michelle Auten | Case Manager/Care Coordinator | 102 Heritage Way Ne Ste 302, Leesburg, VA 20176-4544 | 2016-01-27 |
| 1659738748 | Daniel Burns | Case Manager/Care Coordinator | 102 Heritage Way Ne, Suite 302 P.o., Leesburg, VA 20176-4544 | 2016-01-21 |
| Find all providers in LEESBURG | ||||
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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.