JENNIFFER COLLEEN CLARK I (NPI# 1861996217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861996217 |
| Entity Type | Individual |
| Full Name | JENNIFFER COLLEEN CLARK I |
| Practice Address |
1115 Har-ber Rd Grove OK 74344 |
| Mailing Address |
1115 Harbor Rd Grove OK 74344-7918 |
| Practice Telephone | 9187864434 |
| Mailing Telephone | 9187864434 |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-04-23 |
| 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 |
| Street Address |
1115 HAR-BER RD |
| City | GROVE |
| State | OK |
| Zip Code | 74344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326604935 | Deborah Stauss | Massage Therapist | 2086 S Main St, Grove, OK 74344 | 2019-05-20 |
| 1841776705 | Progressive Orthotic & Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 10 E 6th St., Grove, OK 74344 | 2018-07-13 |
| 1205329232 | Andra Renee Mitchell | Speech-Language Pathologist | 825 E Third Street, Grove, OK 74344 | 2018-06-13 |
| 1417458167 | Jason S Beckham | Case Manager/Care Coordinator | 32600 S. 625 Road, Grove, OK 74344 | 2018-02-27 |
| 1659872034 | Keli Elaine Whitlock | Peer Specialist | 5602 Us Hwy 59, Grove, OK 74344 | 2018-02-22 |
| 1851899454 | Nichole Marie Wooton | Case Manager/Care Coordinator | 1115 Har-ber Road, Grove, OK 74344 | 2018-01-29 |
| 1043766645 | Samantha Lane | Speech-Language Pathologist | 1046 Hillside Road, Grove, OK 74344 | 2016-09-01 |
| 1376927509 | Matthew Kyle Allen | Physical Therapy Assistant | 4621 Hwy 59 N, Grove, OK 74344 | 2015-07-17 |
| 1477807428 | Andrew Scott Littlejohn | Physical Therapy Assistant | 103 Harber Road, Grove, OK 74344 | 2012-10-30 |
| 1437475027 | Robert William Swan | Obstetrics & Gynecology | 904 Inwood Drive, Grove, OK 74344 | 2010-04-08 |
| Find all providers in zip 74344 | ||||
| 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 |
|---|---|---|---|---|
| 1851913552 | Julie R Bergman | Case Manager/Care Coordinator | 65263 E 256 Pl, Grove, OK 74344-6171 | 2020-05-15 |
| 1558992784 | Jeremy Douglas Goggans | Case Manager/Care Coordinator | 1115 S Harber Road, Grove, OK 74344-3505 | 2020-01-27 |
| 1487115432 | Casey Lynn Reed | Case Manager/Care Coordinator | 25298 S 627 Rd, Grove, OK 74344-7449 | 2019-03-30 |
| 1417458167 | Jason S Beckham | Case Manager/Care Coordinator | 32600 S. 625 Road, Grove, OK 74344 | 2018-02-27 |
| 1316447832 | Tiffany Candace Rowe | Case Manager/Care Coordinator | 101 N Emma St, Grove, OK 74344-3105 | 2018-02-21 |
| 1851899454 | Nichole Marie Wooton | Case Manager/Care Coordinator | 1115 Har-ber Road, Grove, OK 74344 | 2018-01-29 |
| 1063940518 | W. Jay Rector II | Case Manager/Care Coordinator | 26601 S 613 Rd, Grove, OK 74344-7474 | 2017-05-29 |
| 1568914034 | Sonya Mcgough | Case Manager/Care Coordinator | 32700 S 660 Rd, Grove, OK 74344-7631 | 2016-10-31 |
| 1558979831 | Amber Rae Coker | Case Manager/Care Coordinator | 1115 Harbor Rd, Grove, OK 74344-3505 | 2020-07-22 |
| 1275157166 | Katharine Jean Downing | Case Manager/Care Coordinator | 1115 Harbor Rd, Grove, OK 74344-3505 | 2020-06-05 |
| Find all providers in GROVE | ||||
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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.