SIMJAE C HOLMAN-RAYOS (NPI# 1245876713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245876713 |
| Entity Type | Individual |
| Full Name | SIMJAE C HOLMAN-RAYOS |
| Practice Address |
2808 S Picher Ave Joplin MO 64804-1645 |
| Mailing Address |
Po Box 2526 Joplin MO 64803-2526 |
| Practice Telephone | 4173477850 |
| Mailing Telephone | 4173477579 |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2019-11-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
2808 S PICHER AVE |
| City | JOPLIN |
| State | MO |
| Zip Code | 64804-1645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104908599 | Vicky Lynn Mieseler | Psychologist | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2006-10-19 |
| 1891302139 | Hannah Carder | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-09-30 |
| 1295348704 | Elizabeth A Asher | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-08-25 |
| 1184237695 | Lauren G Hancock | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-08-25 |
| 1124637871 | Lerin D Eddings | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-07-29 |
| 1295344943 | Roi Kent Krokower | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-07-29 |
| 1548878986 | Julia K Bruce | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-07-22 |
| 1417565854 | Hope E Fortuck | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-07-22 |
| 1922616366 | Amanda A Talley | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-07-22 |
| 1669080099 | Lindsay E Honsicker | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-07-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718903 | Lisa Jo Moore | Nurse Practitioner | 2623 S Main Street, Nixa, MO 64804 | 2020-10-22 |
| 1346859600 | Centered and Connected LLC | Counselor | 2401 E 32nd St, Ste 10 #103, Joplin, MO 64804 | 2020-07-23 |
| 1649838780 | Nicole Lynn Egan | Social Worker | 3010 Mcclelland, Joplin, MO 64804 | 2019-06-04 |
| 1902361652 | Redings Mill Internal Care | Clinic/Center | 454 Redings Mill Rd, Joplin, MO 64804 | 2019-02-06 |
| 1447732508 | Urgent Care Travel, Inc | Clinic/Center | 5931 E 32nd Street, Joplin, MO 64804 | 2018-09-05 |
| 1912488891 | Karl G. Keczkemethy | Dietitian, Registered | 100 Mercy Way Ste 570, Joplin, MO 64804 | 2018-08-28 |
| 1790207546 | Jacksie Short | Dentist | 2819 E 29th St, Joplin, MO 64804 | 2017-07-13 |
| 1326574625 | Kristine Kwon Rowland | Nurse Practitioner | 100 Mercy Way Ste 320-330, Joplin, MO 64804 | 2017-05-05 |
| 1942735212 | West R Loveland | Counselor | 3230 S Wisconsin St Suite H, Joplin, MO 64804 | 2017-04-25 |
| 1174070205 | Tracy L Fry | Nurse Practitioner | 3333 Mcintosh Cir Ste 4, Joplin, MO 64804 | 2016-09-07 |
| Find all providers in zip 64804 | ||||
| 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 |
|---|---|---|---|---|
| 1942711593 | Christopher R Biastock | Case Manager/Care Coordinator | 1821 W 22nd St, Joplin, MO 64804-0229 | 2017-10-22 |
| 1710318704 | Jennifer Smith | Case Manager/Care Coordinator | 3320 Wisconsin, Joplin, MO 64804 | 2013-12-02 |
| 1053686535 | Anita Archer | Case Manager/Care Coordinator | 3531 N Range Line Rd, Joplin, MO 64801-9778 | 2012-03-15 |
| 1891302139 | Hannah Carder | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-09-30 |
| 1295348704 | Elizabeth A Asher | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-08-25 |
| 1184237695 | Lauren G Hancock | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-08-25 |
| 1124637871 | Lerin D Eddings | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-07-29 |
| 1295344943 | Roi Kent Krokower | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-07-29 |
| 1548878986 | Julia K Bruce | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-07-22 |
| 1417565854 | Hope E Fortuck | Case Manager/Care Coordinator | 2808 S Picher Ave, Joplin, MO 64804-1645 | 2020-07-22 |
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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.