KORMYN SHAY SIMS (NPI# 1215216593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215216593 |
| Entity Type | Individual |
| Full Name | KORMYN SHAY SIMS |
| Practice Address |
100 Rivendell Dr Benton AR 72019-9188 |
| Mailing Address |
100 Rivendell Drive Benton AR 72019 |
| Practice Telephone | 8705725005 |
| Practice Fax Number | 8705725000 |
| Mailing Telephone | 8705725005 |
| Mailing Fax Number | 8705725000 |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |
| 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 |
100 RIVENDELL DR |
| City | BENTON |
| State | AR |
| Zip Code | 72019-9188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063482735 | Uhs of Benton, LLC | Psychiatric Hospital | 100 Rivendell Dr, Benton, AR 72015-9188 | 2006-01-25 |
| 1104303353 | Taylor M Davis | Social Worker | 100 Rivendell Dr, Benton, AR 72019 | 2018-07-20 |
| 1922335728 | Patricia Williams | Social Worker | 100 Rivendell Dr, Benton, AR 72019-9188 | 2009-11-16 |
| 1275869133 | Karen Myler | Counselor | 100 Rivendell Dr, Benton, AR 72019-9188 | 2009-10-28 |
| 1891021754 | Margaret Lynne Baer | Social Worker | 100 Rivendell Dr, Benton, AR 72019-9188 | 2009-10-28 |
| 1962737585 | Tami Hill | Case Manager/Care Coordinator | 100 Rivendell Dr, Benton, AR 72019-9188 | 2009-10-15 |
| 1629303979 | Joseph Karl Lester Jr. | Social Worker | 100 Rivendell Dr, Benton, AR 72019-9188 | 2009-10-05 |
| 1497982714 | Lauren Patricia Watson | Case Manager/Care Coordinator | 100 Rivendell Dr, Benton, AR 72019-9188 | 2009-06-12 |
| 1497981146 | Reshunda Hunter | Case Manager/Care Coordinator | 100 Rivendell Dr, Benton, AR 72019-9188 | 2009-06-09 |
| 1861631954 | Donald Ray Austin | Case Manager/Care Coordinator | 100 Rivendell Dr, Benton, AR 72019-9188 | 2009-02-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898293 | Arkansas Heart Hospital LLC | General Acute Care Hospital | 1901 Encore Way, Bryant, AR 72019 | 2020-10-16 |
| 1306485545 | Ryan Adams | Pharmacist | 20820 I-30 North, Benton, AR 72019 | 2020-01-06 |
| 1649819962 | Josh Landrum | Pharmacist | 20820 I 30 N, Benton, AR 72019 | 2020-01-03 |
| 1710525720 | Melanie Mabry | Nurse Practitioner | 11510 State Highway 298, Benton, AR 72019 | 2019-12-20 |
| 1578086864 | Ronald Winkler | Occupational Therapy Assistant | 2907 Hurricane Lake Rd, Bryant, AR 72019 | 2017-07-19 |
| 1801243357 | Richard Andrew Dwiggins | Social Worker | 1718 Old Hot Springs Highway, Benton, AR 72019 | 2016-05-14 |
| 1184008377 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 2080 I-30 North, Benton, AR 72019 | 2015-07-17 |
| 1689910051 | Rachel Cloud | Physical Therapist | 2010 Activeway, Benton, AR 72019 | 2012-12-12 |
| 1538444583 | Stacy Ann Harris | Specialist | 403 Demuth Lane, Benton, AR 72019 | 2011-10-20 |
| 1144528423 | Robert Mark Robinson | Licensed Practical Nurse | 5 Hickory Ridge Drive, Benton, AR 72019 | 2011-03-10 |
| Find all providers in zip 72019 | ||||
| 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 |
|---|---|---|---|---|
| 1508493404 | Nahum Prophet | Case Manager/Care Coordinator | 3610 Coleman Rd, Benton, LA 71006-9675 | 2020-03-23 |
| 1790343135 | Justin King | Case Manager/Care Coordinator | 1502 Mary Kay Blv6, Benton, AR 72015 | 2019-05-31 |
| 1225551278 | Jessica R Poe | Case Manager/Care Coordinator | 1502 Marykay Blvd, Benton, AR 72015 | 2017-07-21 |
| 1003357997 | Jamaal Langston | Case Manager/Care Coordinator | 1502 Mark Kay Blvd, Benton, AR 72015 | 2017-03-13 |
| 1265715072 | James Michael Bell | Case Manager/Care Coordinator | 1502 Mary Kaye Blvd, Benton, AR 72015-8909 | 2011-09-28 |
| 1386934206 | Debra A Davis | Case Manager/Care Coordinator | 6701 Hwy 67 S. Bldg 4, Benton, AR 72015 | 2011-04-12 |
| 1174833016 | Allen Cooper | Case Manager/Care Coordinator | 6701 Hwy 67 S Bldg 4, Benton, AR 72015 | 2010-10-13 |
| 1942454517 | Kathy James | Case Manager/Care Coordinator | 2270 Helmich Dr, Benton, AR 72019-8322 | 2008-11-10 |
| 1194994558 | Roshunda Denise Foreman | Case Manager/Care Coordinator | 307 E Sevier, Benton, AR 72015 | 2008-02-29 |
| 1609063791 | Sean Rock | Case Manager/Care Coordinator | 307 E Sevier St., Counseling Clinic Inc, Benton, AR 72015 | 2007-10-02 |
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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.