ALTRECIA L JACKSON


Address: 7209 Louise St, Shreveport, LA 71108-4844
Phone: 3183448365

ALTRECIA L JACKSON (NPI# 1114459666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114459666
Entity Type Individual
Full Name ALTRECIA L JACKSON
Credential LPN
Practice Address 7209 Louise St
Shreveport
LA 71108-4844
Mailing Address 3341 Youree Drive
Shreveport
LA 71105
Practice Telephone 3183448365
Mailing Telephone 3183448365
Enumeration Date 2017-04-03
Last Update Date 2019-01-03
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 164W00000X Licensed Practical Nurse 880566 LA Nursing Service Providers
Y 171M00000X Case Manager/Care Coordinator Other Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
LA LPN 880566 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
3341 Youree Dr, Shreveport, LA 711052149 3183448365

Office Location

Street Address 7209 LOUISE ST
City SHREVEPORT
State LA
Zip Code 71108-4844

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1528551140 Berkelia Player Case Manager/Care Coordinator 8108 Kingston Road Suite 101 B, Shreveport, LA 71108 2018-06-08
1548757305 Kenya Cawthorne Counselor 1520 Oakdale St, Shreveport, LA 71108 2018-04-17
1083112890 Chantanell Johns Case Manager/Care Coordinator 8101 Kingston Rd Ste 101b, Shreveport, LA 71108 2018-01-26
1912425935 Mildred Rivers Case Manager/Care Coordinator 4718 Hearne Ave, Shreveport, LA 71108 2017-08-30
1790205326 Britney Ashton Case Manager/Care Coordinator 1910 Hickory St, Shreveport, LA 71108 2017-06-24
1548792674 La'travia Jackson Case Manager/Care Coordinator 3430 Fernwood Ln, Shreveport, LA 71108 2017-03-29
1962941476 Johnetta Marshall Counselor 6901 Despot Rd, Shreveport, LA 71108 2017-02-16
1295283992 Shaun Cooper Case Manager/Care Coordinator 8824 Ruth Ave, Shreveport, LA 71108 2016-09-12
1508313735 Tara Black Counselor 7019 Louise St, Shreveport, LA 71108 2016-09-06
1659828960 Maranda Bolden Counselor 4906 Merlin Circle, Apt 4906, Shreveport, LA 71108 2016-09-02
Find all providers in zip 71108

Taxonomy Information

Taxonomy Code 171M00000X
Grouping Other Service Providers
Classification Case Manager/Care Coordinator

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1497360887 Halena Jones Case Manager/Care Coordinator 9409 Chaparral Ln, Shreveport, LA 71118-4337 2020-09-11
1598376196 Michaela Nicole Bradley Case Manager/Care Coordinator 10021 Stratmore Cir, Shreveport, LA 71115-3416 2020-08-17
1619585791 Kimberly Bissell Case Manager/Care Coordinator 7505 Pines Rd Ste 1115, Shreveport, LA 71129-3900 2020-07-15
1902414170 Unique Lashae Lister Case Manager/Care Coordinator 2611 Corbitt St, Shreveport, LA 71108-2805 2020-07-14
1407474828 Angela Harris Case Manager/Care Coordinator 1111 W 70th St Apt 93, Shreveport, LA 71106-3558 2020-07-13
1669096921 Ryan Barham Case Manager/Care Coordinator 824 Oneonta St, Shreveport, LA 71106-1130 2020-06-02
1922621085 Julian White Case Manager/Care Coordinator 8529 Grover Pl, Shreveport, LA 71115-2707 2020-05-24
1396368817 Shannon Marie Cannon Case Manager/Care Coordinator 1543 Summers St, Shreveport, LA 71108-3131 2020-05-19
1730701954 Brianna Mason Case Manager/Care Coordinator 1533 Marshall St, Shreveport, LA 71101-3941 2020-05-11
1295355238 Angela Rice Case Manager/Care Coordinator 2704 Frostwood Dr, Shreveport, LA 71108-5524 2020-04-20
Find all providers in SHREVEPORT

Competitor

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City SHREVEPORT
Zip Code 71108

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Dataset Information

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.

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