AUTUMN SULLIVAN (NPI# 1790187854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790187854 |
| Entity Type | Individual |
| Full Name | AUTUMN SULLIVAN |
| Credential | LMT |
| Practice Address |
1832 Knapps Aly #213 West Linn OR 97068-4667 |
| Mailing Address |
2241 Nw Hoyt St #101 Portland OR 97210-3788 |
| Practice Telephone | 5038160329 |
| Mailing Telephone | 5038160329 |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2014-09-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | 10950 | OR | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184289605 | Autumn Leree Sullivan | Home Health | 1672 Dominion Dr, Akron, OH 44313 | 2019-05-09 |
| Street Address |
1832 KNAPPS ALY #213 |
| City | WEST LINN |
| State | OR |
| Zip Code | 97068-4667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518204916 | Patricia Ann Seemueller | Registered Nurse | 1832 Knapps Aly, Suite 213, West Linn, OR 97068-4667 | 2013-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023678224 | Bethany Joy Bivin | Registered Nurse | 2020 8th Ave Ste 230, West Linn, OR 97068 | 2019-06-19 |
| 1932612777 | Portland Dental Works, LLC | Dentist | 1750 Mckillican, West Linn, OR 97068 | 2017-11-15 |
| 1316460702 | Cameron Johnson Dc LLC | Chiropractor | 21400 Salamo Rd, West Linn, OR 97068 | 2017-07-18 |
| 1376913301 | Genesis Medical Concepts, LLC | Durable Medical Equipment & Medical Supplies | 2020 8th Ave Ste 222, West Linn, OR 97068 | 2015-10-02 |
| 1780052977 | Amanda Carole Tipton | Chiropractor | 21860 Willamette Drive, West Linn, OR 97068 | 2015-09-04 |
| 1457766859 | Eyedeology, Inc | Optometrist | 5656 Hood St. Ste 107, West Linn, OR 97068 | 2014-06-24 |
| 1740694660 | Ariana Bissinger | Nurse Practitioner | 1148 Rosemont Rd, West Linn, OR 97068 | 2014-06-18 |
| 1154606887 | Heather Marie Ellison | Massage Therapist | 22000 Willamette Dr., #107, West Linn, OR 97068 | 2011-10-13 |
| 1336432616 | Lisa Grage | Dental Hygienist | 3551 Coeur D'alene Dr., West Linn, OR 97068 | 2011-05-19 |
| 1316240583 | David Robert Gleave | Psychologist | 1800 Blankenship Rd Ste 200, West Linn, OR 97068 | 2010-12-10 |
| Find all providers in zip 97068 | ||||
| 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 |
|---|---|---|---|---|
| 1083251359 | Christopher Wright | Case Manager/Care Coordinator | 2602 Arbor Dr, West Linn, OR 97068-1104 | 2019-12-05 |
| 1851938120 | Karen Keller | Case Manager/Care Coordinator | 2602 Arbor Dr, West Linn, OR 97068-1104 | 2019-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104539 | Jessica Laine | Case Manager/Care Coordinator | 1724 Maple St Apt 7, North Bend, OR 97459-2171 | 2020-08-14 |
| 1083232862 | Olivia Suzanne Botsford | Case Manager/Care Coordinator | 2369 Nw Schmidt Way Apt 117, Beaverton, OR 97006-4775 | 2020-07-08 |
| 1255958674 | Kathy Hays | Case Manager/Care Coordinator | 17887 Sw Bryan Way, Beaverton, OR 97007-6728 | 2020-07-01 |
| 1437775558 | John Alan Varner | Case Manager/Care Coordinator | 5833 N Lombard St, Portland, OR 97203-4115 | 2020-06-24 |
| 1750906228 | Dwell Care LLC. | Case Manager/Care Coordinator | 1720 Nw Lovejoy St Ste 202, Portland, OR 97209-2341 | 2020-06-10 |
| 1275169393 | Celina N Taylor | Case Manager/Care Coordinator | 103 Or-82, Enterprise, OR 97828 | 2020-03-20 |
| 1710512736 | Dominic Townsend | Case Manager/Care Coordinator | 18715 Sw Blanton St, Aloha, OR 97078-1234 | 2020-03-10 |
| 1659910073 | Kristin Anne Contreras | Case Manager/Care Coordinator | 4850 Sw 11th St Apt 110, Gresham, OR 97080-7312 | 2020-01-02 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1043853716 | Heidi Marie Davis | Case Manager/Care Coordinator | 635 3rd Ave Sw Unit 151, Albany, OR 97321-2625 | 2019-10-24 |
| Find all providers with the same taxonomy | ||||
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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.