JERRAY ANTHONY BRANNON (NPI# 1801940325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801940325 |
| Entity Type | Individual |
| Full Name | JERRAY ANTHONY BRANNON |
| Credential | BS QMHA |
| Practice Address |
131 Ne 102nd Ave Portland OR 97220-4167 |
| Mailing Address |
4715 Ne 103rd Ave Portland OR 97220-3343 |
| Practice Telephone | 5032536754 |
| Practice Fax Number | 5032511344 |
| Mailing Telephone | 5033097071 |
| Mailing Fax Number | 5034931635 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-07-08 |
| 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 |
131 NE 102ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-4167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366464570 | Jeffery Franklin Foster | Counselor | 131 Ne 102nd Ave, Portland, OR 97220-4167 | 2006-07-24 |
| 1265657159 | Amy Ruth | Psychiatry & Neurology | 131 Ne 102nd Ave, Portland, OR 97220-4167 | 2007-04-16 |
| 1679610018 | Susan Mawdesley Haines | Counselor | 131 Ne 102nd Ave, Portland, OR 97220-4167 | 2007-02-01 |
| 1881731750 | Deborah Jeanne Wright | Counselor | 131 Ne 102nd Ave, Portland, OR 97220-4167 | 2007-01-31 |
| 1245376730 | Carmen Tara Corbin II | Counselor | 131 Ne 102nd Ave, Portland, OR 97220-4167 | 2007-01-30 |
| 1568509677 | James John Heidrick | Counselor | 131 Ne 102nd Ave, Portland, OR 97220-4167 | 2007-01-30 |
| 1184760019 | Carol A Schmidt | Case Manager/Care Coordinator | 131 Ne 102nd Ave, Portland, OR 97220-4167 | 2007-01-29 |
| 1023154846 | Brooke Ann Sheehan | Nurse Practitioner | 131 Ne 102nd Ave, Portland, OR 97220-4167 | 2007-01-29 |
| 1861544033 | Stacy Lynn Riser | Counselor | 131 Ne 102nd Ave, Portland, OR 97220-4167 | 2007-01-17 |
| 1104912872 | Diane K Rose | Counselor | 131 Ne 102nd Ave, Portland, OR 97220-4167 | 2006-10-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102077 | Joslyn Bailey Gheen | Case Manager/Care Coordinator | 1032 Sw Main St, Portland, OR 97205-2407 | 2019-09-05 |
| 1497311773 | Ali Tareq Ashour | Case Manager/Care Coordinator | 980 Forest Ave Ste 106, Portland, ME 04103-3357 | 2019-05-13 |
| 1427540202 | Amber Tracy Ware | Case Manager/Care Coordinator | 30 Ne Martin Luther King Jr Blvd, Portland, OR 97232-2941 | 2018-06-06 |
| 1710479209 | Katherine Anne Kerr | Case Manager/Care Coordinator | 4307 Ne 102nd Ave, Portland, OR 97220-3439 | 2018-05-31 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1083137459 | David Sague | Case Manager/Care Coordinator | 7820 Ne Holman St Ste B5, Portland, OR 97218-2841 | 2017-07-18 |
| 1538601885 | Gabriela Simone Sargent | Case Manager/Care Coordinator | 4109 Se 113th Ave, Portland, OR 97266-2226 | 2016-11-16 |
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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.