JOHNATHON MITT WILSON (NPI# 1164765681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164765681 |
| Entity Type | Individual |
| Full Name | JOHNATHON MITT WILSON |
| Credential | B.S.W |
| Practice Address |
781 36th St Se Grand Rapids MI 49548-2319 |
| Mailing Address |
Po Box 141 Grand Rapids MI 49501-0141 |
| Practice Telephone | 7343958652 |
| Practice Fax Number | 6162432302 |
| Mailing Telephone | 7343958652 |
| Mailing Fax Number | 6162432302 |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2013-04-03 |
| Gender Code | M |
| 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 |
781 36TH ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49548-2319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255883252 | Kaleigh Nicole Kleyn | Case Manager/Care Coordinator | 781 36th St Se, Grand Rapids, MI 49548-2319 | 2016-10-26 |
| 1154774701 | Hannah Zwart | Case Manager/Care Coordinator | 781 36th St Se, Grand Rapids, MI 49548-2319 | 2016-07-19 |
| 1962884387 | Leezanne Zeng | Family Medicine | 781 36th St Se, Grand Rapids, MI 49548-2319 | 2015-06-22 |
| 1700287448 | Trinity Health - Michigan | Clinic/Center | 781 36th St Se, Grand Rapids, MI 49548-2319 | 2014-09-12 |
| 1447663844 | Garrett Caldwell | Family Medicine | 781 36th St Se, Grand Rapids, MI 49548-2319 | 2014-06-04 |
| 1326477209 | Justine Sawyer | Case Manager/Care Coordinator | 781 36th St Se, Grand Rapids, MI 49548-2319 | 2013-11-01 |
| 1518304716 | Katherine Mae Mokma | Case Manager/Care Coordinator | 781 36th St Se, Grand Rapids, MI 49548-2319 | 2013-05-29 |
| 1679811780 | Shari L Hasford | Case Manager/Care Coordinator | 781 36th St Se, Grand Rapids, MI 49548-2319 | 2013-01-24 |
| 1386982890 | Nikkea Kelley | Case Manager/Care Coordinator | 781 36th St Se, Grand Rapids, MI 49548-2319 | 2013-01-18 |
| 1417291436 | Carrie Pebley | Social Worker | 781 36th St Se, Grand Rapids, MI 49548-2319 | 2012-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205319811 | Pooja Patel | Social Worker | Spectrum Community Services, 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2018-09-10 |
| 1063906865 | Kimberly Eccher | Physician Assistant | 300 68th St. Se, Grand Rapids, MI 49548 | 2018-06-15 |
| 1871099481 | Baymark of Michigan, Inc. | Clinic/Center | 5500 Division Avenue Se, Kentwood, MI 49548 | 2018-04-03 |
| 1629507801 | Laura Marie Quennoz | Psychiatry & Neurology | Pine Rest Christian Mental Health Services, 300 68th Street Se, Grand Rapids, MI 49548 | 2017-06-09 |
| 1821548504 | Alison Anderson | Technician, Other | 103 Roth St Se, Grand Rapids, MI 49548 | 2016-10-06 |
| 1831540152 | Jesse Aubil | Counselor | 264 Montebello St. Se 49548, Grand Rapids, MI 49548 | 2016-06-28 |
| 1306237920 | Sarah Benton | Social Worker | 225 Colrain St Sw, 2, Grand Rapids, MI 49548 | 2015-02-18 |
| 1578996856 | Karen Marie Irving | Social Worker | 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2013-08-09 |
| 1740348044 | Robert Kenneth Richmond | Preventive Medicine | 551 36th Street. Se, Wyoming, MI 49548 | 2006-12-05 |
| 1386738953 | Sharita Montiez Hall | Social Worker | 300 68th Street Se, Grand Rapids, MI 49548 | 2006-10-03 |
| Find all providers in zip 49548 | ||||
| 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 |
|---|---|---|---|---|
| 1144837618 | Lisa Glover | Case Manager/Care Coordinator | 1977 Radcliff Ave Se, Grand Rapids, MI 49506-5140 | 2020-09-28 |
| 1861001273 | Erica Curry Van Ee | Case Manager/Care Coordinator | 600 Broadway Ave Nw Apt 224, Grand Rapids, MI 49504-7316 | 2020-07-31 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1861048811 | Jenelle Marie Dixon | Case Manager/Care Coordinator | 1228 Dunham St Se, Grand Rapids, MI 49506-2630 | 2019-08-15 |
| 1730747700 | Renee Kimberly Howard | Case Manager/Care Coordinator | 939 Mayhew Wood Dr Se, Grand Rapids, MI 49507-3609 | 2019-06-04 |
| 1710543806 | Shannon Marie Blourne | Case Manager/Care Coordinator | 814 Alpine Ave Nw, Grand Rapids, MI 49504-4410 | 2019-05-14 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1508371758 | Vanessa Woodard | Case Manager/Care Coordinator | 1939 S. Division Ave., Grand Rapids, MI 49507 | 2017-12-11 |
| 1407386352 | Keri Megan Laporte-montero | Case Manager/Care Coordinator | 434 Sweet St Ne, Grand Rapids, MI 49505-4762 | 2017-06-14 |
| 1396111241 | Kirsten Elizabeth Tanui | Case Manager/Care Coordinator | 2606 Eastern Ave Se, Grand Rapids, MI 49507-3605 | 2015-08-14 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49548 |
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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.