KELLEY RENE MOORE (NPI# 1205026531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205026531 |
| Entity Type | Individual |
| Full Name | KELLEY RENE MOORE |
| Other Name | MARIE SHELTON |
| Credential | MHPP |
| Practice Address |
4425 Jefferson Ave Suite 106 Texarkana AR 71854-1535 |
| Practice Telephone | 8702161700 |
| Mailing Telephone | 8702161700 |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2007-08-01 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598958647 | Kelley Newman Moore | Dentist | 1 Orange Ave, Rockledge, FL 32955-2945 | 2007-08-22 |
| 1740326289 | Kelley K. Moore | Psychiatry & Neurology | 4851 Independence St., 70 Executive Center, Wheat Ridge, CO 80033-6715 | 2007-01-30 |
| 1871084335 | Kelley Moore | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103-3324 | 2018-05-21 |
| 1417313784 | Kelley Nicole Moore | Pharmacist | 3745 Louisiana Ave S, St Louis Park, MN 55426-4361 | 2016-01-02 |
| 1679823538 | Kelley Michelle Moore | Case Manager/Care Coordinator | 1911 Williams Dr, Oxnard, CA 93036-2612 | 2012-09-18 |
| 1639165343 | Kelley C Moore | Nurse Anesthetist, Certified Registered | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2005-09-27 |
| Street Address |
4425 JEFFERSON AVE SUITE 106 |
| City | TEXARKANA |
| State | AR |
| Zip Code | 71854-1535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679686414 | Nathan Edward Pearlman | Counselor | 4425 Jefferson Ave, Suite 106, Texarkana, AR 71854-1535 | 2006-08-16 |
| 1174753644 | J & L Hearing Center | Hearing Aid Equipment | 4425 Jefferson Ave, Suite 101, Texarkana, AR 71854-1535 | 2009-07-19 |
| 1255569505 | Ella Lucille Carroll | Hearing Aid Equipment | 4425 Jefferson Ave, Suite 101, Texarkana, AR 71854 | 2009-06-25 |
| 1427283548 | Chelsey Gillion | Counselor | 4425 Jefferson Ave, Texarkana, AR 71854 | 2009-05-19 |
| 1700011822 | Christopher Shupe | Counselor | 4425 Jefferson Ave, Texarkana, AR 71854 | 2009-05-19 |
| 1164657284 | Jerita Barron | Counselor | 4425 Jefferson Ave, Texarkana, AR 71854 | 2009-05-19 |
| 1477714657 | Theresa Renne Fields | Case Manager/Care Coordinator | 4425 Jefferson Ave, Suite 106, Texarkana, AR 71854-1535 | 2008-06-20 |
| 1891971875 | Jimmy Leon Phillips Jr. | Case Manager/Care Coordinator | 4425 Jefferson Ave, Suite 106, Texarkana, AR 71854-1535 | 2008-01-21 |
| 1811182116 | Valleria Needham | Counselor | 4425 Jefferson Ave, Suite 106, Texarkana, AR 71854-1535 | 2007-09-10 |
| 1891988754 | Shauna Noel Ferland | Registered Nurse | 4425 Jefferson Ave, Suite 106, Texarkana, AR 71854-1535 | 2007-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962988253 | Holly Renee Snipe | Registered Nurse | 4700 Sunbury Dr, Texarkana, AR 71854 | 2018-07-19 |
| 1023500634 | Carlotta A Powell | Counselor | 7000 N Stateline Ave, Texarkana, AR 71854 | 2018-05-31 |
| 1326538810 | Chad Roldan | Occupational Therapy Assistant | 6402 Countryside Dr, Texarkana, AR 71854 | 2018-05-10 |
| 1649797481 | Alliance Counseling Agency LLC | Community/Behavioral Health | 819 Beech St, Texarkana, AR 71854 | 2017-08-23 |
| 1366971467 | Kimberly Dian Cox | Case Manager/Care Coordinator | 7000 North Stateline Ave, Texarkana, AR 71854 | 2017-06-12 |
| 1295260040 | Seniors for Senior Care | Adult Companion | 4613 Parkway Dr., Texarkana, AR 71854 | 2017-04-28 |
| 1033650635 | Texarkana Eye Associates | Optometrist | 114 East 49th St, Texarkana, AR 71854 | 2017-03-15 |
| 1881064731 | Texarkana Group, P.l.l.c | Chiropractor | 2100 N. State Line Ave., Texarkana, AR 71854 | 2015-10-05 |
| 1528301819 | Megan Guercio | Specialist/Technologist | 1002 East 35th Street, Texarkana, AR 71854 | 2013-04-04 |
| 1831439116 | James Wesley Mcraven | Nurse Practitioner | 210 N. Stateline, Suite 301, Texarkana, AR 71854 | 2013-02-22 |
| Find all providers in zip 71854 | ||||
| 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 |
|---|---|---|---|---|
| 1477198299 | Regina Deshae Dunagin | Case Manager/Care Coordinator | 3913 Sabine Ave, Texarkana, TX 75503-2840 | 2019-11-15 |
| 1245740943 | Darnell Brown Community Development Corporation | Case Manager/Care Coordinator | 922 Garland Ave, Texarkana, AR 71854-5055 | 2017-10-07 |
| 1366971467 | Kimberly Dian Cox | Case Manager/Care Coordinator | 7000 North Stateline Ave, Texarkana, AR 71854 | 2017-06-12 |
| 1467723387 | Andrea Yvonne Jones | Case Manager/Care Coordinator | 1701 County Ave, Texarkana, AR 71854-4303 | 2012-01-24 |
| 1942510953 | Amber Beasley | Case Manager/Care Coordinator | 701 Arkansas Blvd., Texarkana, AR 71854 | 2010-10-13 |
| 1437468956 | Mary Mobley | Case Manager/Care Coordinator | 1202 N Stateline Ave, Texarkana, AR 71854-2919 | 2010-10-01 |
| 1649893991 | Kaitlyn Renee Yancey | Case Manager/Care Coordinator | 2904 Arkansas Blvd, Texarkana, AR 71854-2536 | 2020-05-21 |
| 1417578154 | Carrie Ann James | Case Manager/Care Coordinator | 2904 Arkansas Blvd, Texarkana, AR 71854-2536 | 2020-05-05 |
| 1992330435 | Reagen Richburg | Case Manager/Care Coordinator | 2904 Arkansas Blvd, Texarkana, AR 71854-2536 | 2020-03-05 |
| 1396382412 | Symone Autrey | Case Manager/Care Coordinator | 2904 Arkansas Blvd, Texarkana, AR 71854-2536 | 2019-12-09 |
| Find all providers in TEXARKANA | ||||
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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.