KENNETH ELLIS (NPI# 1992212633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992212633 |
| Entity Type | Individual |
| Full Name | KENNETH ELLIS |
| Credential | CASE MANAGER |
| Practice Address |
1802 Hwy 82 West Crossett AR 71635 |
| Mailing Address |
790 Roberts Dr Monticello AR 71655-5723 |
| Practice Telephone | 8703647248 |
| Practice Fax Number | 8703642249 |
| Mailing Telephone | 8703672461 |
| Mailing Fax Number | 8704606133 |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | AR | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154403210 | Kenneth Nickolas Ellis | Dentist | 7995 Bellfort St, Houston, TX 77061-1960 | 2006-10-19 |
| 1417973850 | Kenneth J Ellis | Psychologist | 1106 Columbia Ave, Suite 100, Marysville, WA 98270-4335 | 2006-07-15 |
| 1215981022 | Kenneth R Ellis | Ophthalmology | 1213 24th St, Suite 300, Anacortes, WA 98221-2592 | 2006-05-19 |
| 1447248133 | Kenneth Ellis | Anesthesiology | 1099 Augusta Falls Way, Naples, FL 34119-1362 | 2005-10-07 |
| 1700103934 | Kenneth Ray Ellis | Specialist | 2243 Eddie Williams Rd, Johnson City, TN 37601-2872 | 2010-04-28 |
| 1215017694 | Kenneth R Ellis | Psychologist | 5525 Twin Knolls Rd, Suite 327, Columbia, MD 21045-3266 | 2006-10-17 |
| 1114902228 | Kenneth K Ellis | Internal Medicine | 11111 Research Blvd, Suite 390, Austin, TX 78759-5264 | 2005-12-12 |
| Street Address |
1802 HWY 82 WEST |
| City | CROSSETT |
| State | AR |
| Zip Code | 71635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851526602 | Paula Aletha Wall | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2009-05-22 |
| 1760950786 | Jaquario D Miles | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2018-11-07 |
| 1205233152 | Stacy E Cunningham | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2014-11-20 |
| 1376955765 | Barron Sheree Brown | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2014-05-20 |
| 1326466863 | Alisha Chantel Tucker | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2014-04-02 |
| 1508296948 | Kasie Marie Barrow Mccaughan | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2013-11-21 |
| 1427496637 | Christian L Kidd | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2013-06-10 |
| 1346684149 | Terri T Bryant | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2013-04-23 |
| 1629314117 | Alicia Nichole Gill | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2013-01-02 |
| 1174834071 | Ruby J Johnson | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2010-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861873929 | Kayley A Harris | Social Worker | 1308 West 5th, Crossett, AR 71635 | 2015-06-15 |
| 1134552136 | Shonta G. Paskel | Licensed Practical Nurse | 1308 W. 5th Street, Crossett, AR 71635 | 2013-08-13 |
| 1861708885 | Stonegate Villa Health and Rehabilitation LLC | Skilled Nursing Facility | 118 Jerry Selby Drive, Crossett, AR 71635 | 2010-08-27 |
| 1457688673 | Crystal L Pippen | Case Manager/Care Coordinator | 1308 W. 5th St., Crossett, AR 71635 | 2009-11-09 |
| 1982855979 | Megan T Harris | Counselor | 615 W 1st Avenue, Crossett, AR 71635 | 2008-10-08 |
| 1063661882 | Helen Davis | Social Worker | 1308 W 5th Street, Crossett, AR 71635 | 2008-09-17 |
| 1043469869 | Shajuana Brown | Social Worker | 1308 West 5th St., Crossett, AR 71635 | 2008-09-17 |
| 1750537387 | Wanda F Hicks | Licensed Practical Nurse | 1308 West 5th Ave, Crossett, AR 71635 | 2008-08-14 |
| 1760654156 | John R Garlington | Psychologist | 1308 West 5th Street, Crossett, AR 71635 | 2008-03-26 |
| 1528193877 | Evon Moore | Case Manager/Care Coordinator | 1802 Hwy 82 W, Crossett, AR 71635 | 2007-02-23 |
| Find all providers in zip 71635 | ||||
| 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 |
|---|---|---|---|---|
| 1457688673 | Crystal L Pippen | Case Manager/Care Coordinator | 1308 W. 5th St., Crossett, AR 71635 | 2009-11-09 |
| 1851526602 | Paula Aletha Wall | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2009-05-22 |
| 1528193877 | Evon Moore | Case Manager/Care Coordinator | 1802 Hwy 82 W, Crossett, AR 71635 | 2007-02-23 |
| 1760950786 | Jaquario D Miles | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2018-11-07 |
| 1285098269 | Felita I Miller | Case Manager/Care Coordinator | 1308 West 5th Street, Crossett, AR 71635 | 2016-04-06 |
| 1205233152 | Stacy E Cunningham | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2014-11-20 |
| 1376955765 | Barron Sheree Brown | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2014-05-20 |
| 1326466863 | Alisha Chantel Tucker | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2014-04-02 |
| 1508296948 | Kasie Marie Barrow Mccaughan | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2013-11-21 |
| 1427496637 | Christian L Kidd | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2013-06-10 |
| Find all providers in CROSSETT | ||||
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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.