KIMBERLY JOHNSON (NPI# 1215397104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215397104 |
| Entity Type | Individual |
| Full Name | KIMBERLY JOHNSON |
| Practice Address |
1312 W Collin Raye Dr De Queen AR 71832-2135 |
| Mailing Address |
2904 Arkansas Blvd Texarkana AR 71854-2536 |
| Practice Telephone | 8705847115 |
| Practice Fax Number | 8706423388 |
| Mailing Telephone | 8707734655 |
| Mailing Fax Number | 8707724650 |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-03-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619020 | Kimberly Little Johnson | Physical Therapy Assistant | 7913 Red Globe Ct, Severn, MD 21144-1047 | 2020-11-05 |
| 1770198657 | Kimberly Ann Johnson | Technician | 171 Teal Rd, Martinsburg, WV 25405-8946 | 2020-09-09 |
| 1255940698 | Kimberly Renee Johnson | Clinical Exercise Physiologist | 5645 Danvers Rd, Portsmouth, VA 23703-3730 | 2020-07-30 |
| 1932722014 | Kimberly Lashonda Johnson | Counselor | 2018 James Overlook Dr, Chester, VA 23836-2851 | 2020-05-22 |
| 1164051850 | Kimberly L Johnson | Home Health | 14055 46th Street North Suite 1102, Clearwater, FL 33762 | 2020-04-03 |
| 1255965596 | Kimberly Ann Johnson | Occupational Therapy Assistant | 16512 Honeybunch Ln Se, Oldtown, MD 21555-1325 | 2020-02-25 |
| 1043788706 | Kimberly Johnson | Occupational Therapist | 8870 Youree Dr Ste 108, Shreveport, LA 71115-2512 | 2018-11-10 |
| 1750866992 | Kimberly Johnson | Driver | 3030 Marcia Louise Dr, Southaven, MS 38672-6750 | 2018-10-02 |
| 1801399928 | Kimberly Johnson | Chiropractor | 487 N Turnpike Rd, Santa Barbara, CA 93111-1955 | 2018-03-15 |
| 1598280984 | Kimberly Sue Johnson | Nurse Practitioner | 1201 7th St Se Ste 120, Decatur, AL 35601-3337 | 2017-08-07 |
| Street Address |
1312 W COLLIN RAYE DR |
| City | DE QUEEN |
| State | AR |
| Zip Code | 71832-2135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235108663 | Sheree Moskow | Psychologist | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2006-03-17 |
| 1730786963 | Sonya Steward | Counselor | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2020-10-01 |
| 1760028708 | Samantha Banhart | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2019-11-25 |
| 1023666351 | Just Wade Younger | Social Worker | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2019-08-29 |
| 1891349676 | Miriam Carreon Morales | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2019-07-30 |
| 1841855012 | Janice Elizabeth Ocampo | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2019-05-03 |
| 1225544315 | Alissa Loren Berruquin | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2017-12-27 |
| 1639605587 | Michael Wayne Barnes | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2017-05-11 |
| 1629503982 | Shawn Mitchell I | Counselor | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2017-04-25 |
| 1952787327 | Zachary W Pinson | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2015-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487149985 | Healthcare Express, LLP | Clinic/Center | 1021 W. Collin Raye Dr., Dequeen, AR 71832 | 2018-06-27 |
| 1982963781 | Callie Montana Miller | Specialist/Technologist | 194 Choctaw Trail, Dequeen, AR 71832 | 2012-05-14 |
| 1023376589 | Dequeen Medical Center | Rehabilitation Hospital | 1306 W Collin Dr., Dequeen, AR 71832 | 2012-05-02 |
| 1083971428 | Renee Logan | Pharmacist | 205 W De Queen Ave., De Queen, AR 71832 | 2012-04-23 |
| 1538434295 | Angela Kay Martin | Nurse Practitioner | 1302 W. Collin Raye Dr., Suite A, Dequeen, AR 71832 | 2012-03-14 |
| 1386950624 | Charles Norman Alston IIi | Dentist | 110 W. De Queen Avenue, De Queen, AR 71832 | 2010-08-24 |
| 1609181783 | De Queen Medical Center Inc | Home Health | 1007 N 14th St, De Queen, AR 71832 | 2010-08-12 |
| 1821301466 | Claire Terece Russell | Nurse Practitioner | 500 E. Collin Raye Dr, Dequeen, AR 71832 | 2010-07-25 |
| 1043445455 | Smiles of Arkansas Dental Center, Pllc | Dentist | 110 West Dequeen Avenue, Suite B, Dequeen, AR 71832 | 2009-05-29 |
| 1538319496 | Kerri Allison Ross | Speech-Language Pathologist | 122 Crestwood Dr., Dequeen, AR 71832 | 2008-09-26 |
| Find all providers in zip 71832 | ||||
| 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 |
|---|---|---|---|---|
| 1104307982 | Jessica Megan Smith | Case Manager/Care Coordinator | 2059 Highway 70 W, De Queen, AR 71832-2933 | 2018-08-28 |
| 1215137922 | Pamela Rene O'neal II | Case Manager/Care Coordinator | 101 North 9th Street, De Queen, AR 71832 | 2007-07-20 |
| 1760028708 | Samantha Banhart | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2019-11-25 |
| 1891349676 | Miriam Carreon Morales | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2019-07-30 |
| 1841855012 | Janice Elizabeth Ocampo | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2019-05-03 |
| 1225544315 | Alissa Loren Berruquin | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2017-12-27 |
| 1639605587 | Michael Wayne Barnes | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2017-05-11 |
| 1952787327 | Zachary W Pinson | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2015-08-07 |
| 1245581339 | Summer Fawne Irvan | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2012-09-28 |
| 1184991994 | Lezlie Carlene Cusher | Case Manager/Care Coordinator | 1312 W Collin Raye Dr, De Queen, AR 71832-2135 | 2011-11-22 |
| Find all providers in DE QUEEN | ||||
Please comment or provide details below to improve the information on KIMBERLY JOHNSON.
| 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.