REBECA GIBBONS (NPI# 1073927430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073927430 |
| Entity Type | Individual |
| Full Name | REBECA GIBBONS |
| Practice Address |
4061 Ward Lake Trl Ellenwood GA 30294-4800 |
| Practice Telephone | 4044389978 |
| Mailing Telephone | 4044389978 |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 904270988A | 05 |
| Street Address |
4061 WARD LAKE TRL |
| City | ELLENWOOD |
| State | GA |
| Zip Code | 30294-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770124323 | Lula Varist Gholson | Counselor | Christian Counselor Ma Lou Gholson, 549 Lamar Drive, Forest Park, GA 30294 | 2019-10-04 |
| 1609428176 | Tykechia Todd | Ambulance | 3644 Caseys Cove, Ellenwood, GA 30294 | 2019-07-15 |
| 1891285243 | Ayana Aqila Thornton | Nurse Practitioner | 5654 Hosea Court, Ellenwood, GA 30294 | 2018-05-11 |
| 1346748837 | Kakethia S. Mack | Nurse Practitioner | 4124 Bosenberry Way, Ellenwood, GA 30294 | 2018-01-30 |
| 1851819312 | Tatiana Marcus | Prosthetist | 3895 Busby Mill Ct., Ellenwood, GA 30294 | 2017-09-05 |
| 1962944991 | Fairview Urgent Care, LLC | Clinic/Center | 4475 West Village Pkwy, Ellenwood, GA 30294 | 2016-11-08 |
| 1982006169 | Kristal Cure | Licensed Practical Nurse | 4057 Madiosn Court, Ellenwood, GA 30294 | 2014-09-19 |
| 1801233515 | 1st Class Learning and Performing Arts | Local Education Agency (LEA) | 5474 Platte Dr, Ellenwood, GA 30294 | 2013-06-04 |
| 1235480138 | Life Wellness Group of Atlanta | Home Delivered Meals | 145 Wilhemina Drive, Ellenwood, GA 30294 | 2012-10-02 |
| 1346548450 | William K Holley IIi | Counselor | 2732 Holly Berry Dr, Ellenwood, GA 30294 | 2011-03-14 |
| Find all providers in zip 30294 | ||||
| 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 |
|---|---|---|---|---|
| 1598907388 | Kathleen Veronica Thomas | Case Manager/Care Coordinator | 2006 Boulder Gate Dr, Ellenwood, Ellenwood, GA 30294-1683 | 2009-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780768 | Covenant Consulting and Practice Management Corp | Case Manager/Care Coordinator | 2900 Weatherstone Cir Se, Conyers, GA 30094-2021 | 2020-11-05 |
| 1194325779 | Stephanie A Jones | Case Manager/Care Coordinator | 517 Fall Creek Ct, Mcdonough, GA 30253-9245 | 2020-10-31 |
| 1952918484 | Andrea Y Daniel | Case Manager/Care Coordinator | 6040 Walters Loop, Columbus, GA 31907-5368 | 2020-09-29 |
| 1730796772 | Abbigail J Boyd | Case Manager/Care Coordinator | 538 Hunterdale Rd, Evans, GA 30809-3630 | 2020-09-24 |
| 1326653890 | Chosen Care, Inc. | Case Manager/Care Coordinator | 5202 Forest Springs Dr, Atlanta, GA 30338-3506 | 2020-09-11 |
| 1689287112 | Nikki Crew | Case Manager/Care Coordinator | 200 Suddeth St, Winterville, GA 30683-1901 | 2020-08-25 |
| 1205448032 | Leona Ramsey Dorsey | Case Manager/Care Coordinator | 19 Shearwater Dr, Fortson, GA 31808-5316 | 2020-08-22 |
| 1467064428 | Kayla M Sims | Case Manager/Care Coordinator | 6475 Calamar Dr, Cumming, GA 30040-7645 | 2020-08-20 |
| 1821600990 | Johnelle Chambers | Case Manager/Care Coordinator | 4045 S Shelby Ln, Douglasville, GA 30135-4141 | 2020-08-20 |
| 1801408919 | April Scott | Case Manager/Care Coordinator | 267 Roberts Rd, Barnesville, GA 30204-3367 | 2020-08-19 |
| 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.