EDMOND LOUIS METELLUS (NPI# 1760984553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760984553 |
| Entity Type | Individual |
| Full Name | EDMOND LOUIS METELLUS |
| Practice Address |
525 Nw Lake Whitney Pl Ste 102 Port St Lucie FL 34986-1605 |
| Mailing Address |
419 Sw Crabapple Cv Port St Lucie FL 34986-2329 |
| Practice Telephone | 7723378164 |
| Mailing Telephone | 9783400839 |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2018-03-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
525 NW LAKE WHITNEY PL STE 102 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34986-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487901187 | Pamela Jewell Givans | Counselor | 525 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1605 | 2012-08-13 |
| 1326507427 | Grace Antoinette Irving | Counselor | 525 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1605 | 2019-03-18 |
| 1740767649 | Chevon Jackson | Counselor | 525 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1605 | 2018-07-24 |
| 1558874164 | Christina Ann Porto | Social Worker | 525 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1605 | 2017-11-06 |
| 1831601871 | Megan G Pack | Case Manager/Care Coordinator | 525 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1605 | 2017-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962992933 | Lindsay B Rojas | Occupational Therapist | 827 Sw Grand Reserves Blvd, Port St Lucie, FL 34986 | 2018-05-15 |
| 1639685266 | Natoya A Queenbourrows | Family Medicine | 2145 Nw Padova St, Port St Lucie, FL 34986 | 2017-12-19 |
| 1740634930 | The Toledo Clinic, LLC | Clinic/Center | 5481 Nw East Torino Parkway, Port St. Lucie, FL 34986 | 2016-04-14 |
| 1326407230 | Merline Smellie | Social Worker | 525 Nw Lake Whitney Place, Ste 102 & 103, Port St Lucie, FL 34986 | 2016-02-19 |
| 1124486949 | Therapy Connection of The Treasure Coast | Speech-Language Pathologist | 549 Nw Lake Whitney Pl Ste 104, Port St Lucie, FL 34986 | 2016-02-08 |
| 1689050015 | Yudelquis Comas Sanchez | Internal Medicine | Lawnwood Regional Medical Center, 1700 S 23rd St, Fort Pierce, FL 34986 | 2015-08-07 |
| 1689056889 | Joshua Chupp | Dentist | 1384 Sw St. Lucie West Blvd, Port St. Lucie, FL 34986 | 2015-06-24 |
| 1366821720 | Kids Therapy Solutions | Occupational Therapist | 161 Sw Palm Dr # 201, Port St Lucie, FL 34986 | 2015-05-19 |
| 1134514086 | Comfortable Care Dental Health Professionals, Pa | Dentist | 1384 Sw St. Lucie, Port St. Lucie, FL 34986 | 2015-03-30 |
| 1750787586 | Timothy Michael Kennedy | Chiropractor | 1680 Sw Saint Lucie West Blvd Ste 204, Port St Lucie, FL 34986 | 2014-11-05 |
| Find all providers in zip 34986 | ||||
| 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 |
|---|---|---|---|---|
| 1285284745 | Ronn Daigle | Case Manager/Care Coordinator | 6701 Woods Island Cir Apt 105, Port St Lucie, FL 34952-1482 | 2019-09-17 |
| 1053872986 | Marie E Solide | Case Manager/Care Coordinator | 1526 Sw Broadview St, Port St Lucie, FL 34983-2993 | 2019-03-25 |
| 1669941506 | Linda Prevalon | Case Manager/Care Coordinator | 4602 Sw Joffre St, Port St Lucie, FL 34953-6638 | 2018-11-21 |
| 1922592864 | Deadra L Nisbeth-lewis | Case Manager/Care Coordinator | 2312 Sw Import Dr, Port St Lucie, FL 34953-5796 | 2018-06-14 |
| 1073028072 | Mayra Fitzgerald | Case Manager/Care Coordinator | 1201 Sw Thomas Ct, Port St Lucie, FL 34953-4271 | 2017-12-12 |
| 1124547989 | Alicia Maria Herrero Marzo | Case Manager/Care Coordinator | 749 Nw Orchid St, Port St Lucie, FL 34983 | 2017-09-13 |
| 1912364886 | Chastity Velez-soto | Case Manager/Care Coordinator | 702 Se White Ave, Port St Lucie, FL 34983-2672 | 2016-01-24 |
| 1801263736 | Maria Entner | Case Manager/Care Coordinator | 11154 Sw Wyndham Way, Port St Lucie, FL 34987-2752 | 2015-08-26 |
| 1790177202 | Freddy Chavarro | Case Manager/Care Coordinator | 237 Sw Sterret Cir, Port St Lucie, FL 34953-3325 | 2015-02-21 |
| 1912309642 | Shalita Pettway | Case Manager/Care Coordinator | 7229 Pine Lakes Blvd, Port St Lucie, FL 34952 | 2014-09-25 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34986 |
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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.