STATE OF MISSOURI (NPI# 1871128645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871128645 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSOURI |
| Other Organization Name | TCM ADULT |
| Practice Address |
1706 E Elm St Jefferson City MO 65101-4130 |
| Mailing Address |
Po Box 687 1706 E Elm St Jefferson City MO 65102-0687 |
| Practice Telephone | 5737513398 |
| Mailing Telephone | 5737513398 |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | MOLLY JANE BOECKMANN (DIRECTOR OF ADMINISTRATIVE SERVICES) |
| Authorized Official Telephone | 5737514055 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF MISSOURI |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Other Name | Type Code |
|---|---|
| TCM Adult | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437781499 | State of Missouri | Rehabilitation Counselor | 3418 Knipp Dr, Jefferson City, MO 65109-5701 | 2020-02-07 |
| 1275073280 | State of Missouri | General Practice | 1547 W Commerce Drive, Marshall, MO 65340-3907 | 2017-02-24 |
| 1528333085 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1000 N Colorado St, Nevada, MO 64772-1618 | 2012-03-16 |
| 1386843621 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15555 Little Blue Rd, Kansas City, MO 64139 | 2007-07-17 |
| 1922207679 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5410 Rinker Rd, Kansas City, MO 64129-2308 | 2007-07-13 |
| 1760681415 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1501 N River Blvd, Independence, MO 64050-1760 | 2007-07-13 |
| 1164630463 | State of Missouri | Intermediate Care Facility, Mentally Retarded | 11 Brady Cir, Overland, MO 63114-1110 | 2007-05-18 |
| 1548322605 | State of Missouri | Day Training, Developmentally Disabled Services | 1500 Vandiver Dr Ste 100, Columbia, MO 65202-3932 | 2006-12-15 |
| 1366503153 | State of Missouri | Day Training, Developmentally Disabled Services | 471 E Slater St, Marshall, MO 65340 | 2006-12-13 |
| 1427118033 | State of Missouri | Day Training, Developmentally Disabled Services | 522 Star St, Marshall, MO 65340 | 2006-12-12 |
| Street Address |
1706 E ELM ST |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65101-4130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659534386 | Cynthia L Hackathorn | Counselor | 1706 E Elm St, Jefferson City, MO 65102 | 2008-07-02 |
| 1316573074 | State of Missouri | Case Manager/Care Coordinator | 1706 E Elm St, Jefferson City, MO 65101-4130 | 2020-03-13 |
| 1578199238 | State of Missouri | Psychologist | 1706 E Elm St, Jefferson City, MO 65101-4130 | 2020-03-13 |
| 1801422621 | State of Missouri | Community/Behavioral Health | 1706 E Elm St, Jefferson City, MO 65101-4130 | 2020-03-13 |
| 1184259913 | State of Missouri | Counselor | 1706 E Elm St, Jefferson City, MO 65101-4130 | 2020-03-12 |
| 1447886288 | State of Missouri | Psychologist | 1706 E Elm St, Jefferson City, MO 65101 | 2020-03-12 |
| 1134577653 | Missouri Department of Mental Health | Clinic/Center | 1706 E Elm St, Jefferson City, MO 65101-4130 | 2016-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619468527 | Lhcg Cxxxxiii, LLC | Home Health | 1125 Madison St Ste C, Jefferson City, MO 65101 | 2018-05-25 |
| 1396254629 | Lauren Mellon | Speech-Language Pathologist | 6124 Falcon Lane, Jefferson City, MO 65101 | 2017-09-29 |
| 1518375708 | Daven Nanda | Pharmacist | 2101 N Schotthill Woods Dr., Jefferson City, MO 65101 | 2014-07-31 |
| 1699183228 | Mark Nitz | Pharmacist | 2101 N Schotthill Dr, Jefferson City, MO 65101 | 2014-07-28 |
| 1386923472 | Lorinda Jo Leer | Occupational Therapist | 1403 Riverside Drive, Jefferson City, MO 65101 | 2011-08-08 |
| 1124334503 | Kimberly K Baumhoer | Hearing Instrument Specialist | 315 Ellis Blvd. Suite 202, Hearing Aid Consultants, Jefferson City, MO 65101 | 2010-08-24 |
| 1780867341 | Health Enhancements, P.C. | Family Medicine | 1739 Elm Court Plaza, Suite 106, Jefferson City, MO 65101 | 2007-12-06 |
| 1336364819 | Jerome Satorre | Occupational Therapist | 505 Ellis Blvd, Apt B20, Jefferson, MO 65101 | 2007-04-17 |
| 1326263450 | Bryan M. Pope, Dds Inc. | Dentist | 200 St. Mary's Medical Plaza, Suite 101, Jefferson City, MO 65101 | 2007-04-16 |
| 1104948769 | Kenneth Mark Skouby | Social Worker | 515a East Mccarty, Jefferson City, MO 65101 | 2007-04-04 |
| Find all providers in zip 65101 | ||||
| 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 |
|---|---|---|---|---|
| 1316573074 | State of Missouri | Case Manager/Care Coordinator | 1706 E Elm St, Jefferson City, MO 65101-4130 | 2020-03-13 |
| 1558633370 | Vicki Lynn Merritt | Case Manager/Care Coordinator | 120 Hospital Dr, Suite 230, Jefferson City, TN 37760-5287 | 2012-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092074 | Strategic Family Solutions, LLC | Case Manager/Care Coordinator | 1904 Ne 80th St, Kansas City, MO 64118-1541 | 2020-10-27 |
| 1528667441 | Ronald York Sr. | Case Manager/Care Coordinator | 1000 N Vandeventer Ave, Saint Louis, MO 63113-3459 | 2020-10-21 |
| 1659983476 | Anthony Thomas Leogrande | Case Manager/Care Coordinator | 122 Briar Meadow Dr, Carl Junction, MO 64834-9690 | 2020-08-21 |
| 1134740004 | Kertonnia Petty-miliken | Case Manager/Care Coordinator | 2570 Mockingbird Ln, Florissant, MO 63031-3611 | 2020-05-02 |
| 1861013732 | Shontay Simpson | Case Manager/Care Coordinator | 37 Saint Anthony Ln, Florissant, MO 63031-6720 | 2020-05-02 |
| 1326677964 | Elaine Baker | Case Manager/Care Coordinator | 120 N Mill St, Festus, MO 63028-1816 | 2020-04-06 |
| 1205487139 | Stacey C Smith | Case Manager/Care Coordinator | 4166 Lindell Blvd Ste 1b, Saint Louis, MO 63108-2923 | 2019-09-23 |
| 1932758125 | Proactive Home Care Missouri | Case Manager/Care Coordinator | 104b W Mount Vernon Blvd, Mount Vernon, MO 65712-1936 | 2019-09-10 |
| 1235781055 | Melony Crayton | Case Manager/Care Coordinator | 800 N Tucker Blvd # Stm, Saint Louis, MO 63101-1008 | 2019-07-11 |
| 1497214118 | Ashley N Nelson | Case Manager/Care Coordinator | 2632 Breckenridge Cir, O Fallon, MO 63368-6669 | 2019-03-13 |
| Find all providers with the same taxonomy | ||||
| City | JEFFERSON CITY |
| Zip Code | 65101 |
Please comment or provide details below to improve the information on STATE OF MISSOURI.
| 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.