RENITA L JACKSON (NPI# 1750924106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750924106 |
| Entity Type | Individual |
| Full Name | RENITA L JACKSON |
| Practice Address |
9532 Wynlakes Pl Montgomery AL 36117-8515 |
| Mailing Address |
10100 Elida Rd Delphos OH 45833-9056 |
| Practice Telephone | 3342703181 |
| Practice Fax Number | 3342705805 |
| Mailing Telephone | 4196958010 |
| Mailing Fax Number | 4196950004 |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831500255 | Renita Jackson | Case Manager/Care Coordinator | 201 W Springdale Ave, Knoxville, TN 37917-5158 | 2014-05-20 |
| Street Address |
9532 WYNLAKES PL |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36117-8515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922010651 | Specialized Alternatives for Families and Youth of America, Inc. | Clinic/Center | 9532 Wynlakes Pl, Montgomery, AL 36117-8515 | 2006-08-12 |
| 1023626645 | Joy D Smith | Social Worker | 9532 Wynlakes Pl, Montgomery, AL 36117-8515 | 2020-07-20 |
| 1740843382 | Ronny Smith | Counselor | 9532 Wynlakes Pl, Montgomery, AL 36117-8515 | 2019-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061307 | Bhg Lxxiii, LLC | Clinic/Center | 1714 Platt Place, Montgomery, AL 36117 | 2020-10-22 |
| 1952945602 | East Montgomery Pediatrics LLC | Pediatrics | 337 St Lukes Drive, Montgomery, AL 36117 | 2019-11-05 |
| 1417421496 | Tiffany Webb | Specialist | 411 Twain Curve, E, Montgomey, AL 36117 | 2019-01-14 |
| 1013485374 | Montgomery Orthodontic Specialists | Dentist | 5833 Carmichael Road, Montgomery, AL 36117 | 2018-11-05 |
| 1770050791 | Blair Henderson Parks | Speech-Language Pathologist | 7088 University Court, Montgomery, AL 36117 | 2018-10-29 |
| 1629557822 | Evelyn F Crayton | Dietitian, Registered | 124 Elm Dr, Montgomery, AL 36117 | 2018-08-08 |
| 1194203414 | Coopers Mental Healh Consultations | Psychologist | 8743 Ridgestone Ct, Montgomery, AL 36117 | 2018-07-30 |
| 1063912301 | Gardenia Cove Mental Health PC | Psychiatry & Neurology | 6771 Taylor Circle, Montgomery, AL 36117 | 2018-02-13 |
| 1760900294 | Montgomery Auburn Homecare LLC | In Home Supportive Care | 2569 Bell Rd, Montgomery, AL 36117 | 2017-09-05 |
| 1336667120 | Alyssa Bryanna Swisher | Chiropractor | 2026 Berryhill Road, Montgomery, AL 36117 | 2017-09-01 |
| Find all providers in zip 36117 | ||||
| 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 |
|---|---|---|---|---|
| 1467001057 | Victoria Alvarez | Case Manager/Care Coordinator | 2088 Sand Hill Ct, Montgomery, IL 60538-6000 | 2019-09-06 |
| 1396390175 | Pamela Kay Patterson | Case Manager/Care Coordinator | 18853 Harbor Side Blvd, Montgomery, TX 77356-3223 | 2019-08-07 |
| 1851861827 | Dera Nassri | Case Manager/Care Coordinator | 16804 Falcon Sound Dr, Montgomery, TX 77356-8386 | 2018-12-03 |
| 1902257306 | Tara Sapp | Case Manager/Care Coordinator | 169 Duffy Ln, Montgomery, LA 71454 | 2016-06-27 |
| 1639383714 | Bethanie Vancamp | Case Manager/Care Coordinator | 10555 Crescendo Ct., Montgomery, OH 45242 | 2007-05-09 |
| 1295854438 | Shamira Hurst | Case Manager/Care Coordinator | 4250 Executive Park Drive, Suite B-100, Montgomery, AL 36116-1619 | 2007-03-28 |
| 1841339561 | Karen Kay Crews | Case Manager/Care Coordinator | 89 April Wind Dr S, Montgomery, TX 77356-5966 | 2007-02-06 |
| 1831707793 | Latanya Morgan-bell | Case Manager/Care Coordinator | 3060 Mobile Hwy, Montgomery, AL 36108-4027 | 2020-07-16 |
| 1912245077 | Melinda Drake | Case Manager/Care Coordinator | 423 S Hull St, Montgomery, AL 36104-4275 | 2013-01-24 |
| 1679695290 | Daniel Mose IIi | Case Manager/Care Coordinator | 4520 Executive Park Dr, Suite B-100, Montgomery, AL 36116-1619 | 2007-04-04 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 36117 |
Please comment or provide details below to improve the information on RENITA L JACKSON.
| 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.