TRACEY JACKSON (NPI# 1255755930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255755930 |
| Entity Type | Individual |
| Full Name | TRACEY JACKSON |
| Practice Address |
820 N Plankinton Ave Milwaukee WI 53203-1802 |
| Practice Telephone | 4142251573 |
| Practice Fax Number | 4142251575 |
| Mailing Telephone | 4142251573 |
| Mailing Fax Number | 4142251575 |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2014-02-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | WI | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134571730 | Tracey Francine Jackson | Technician, Other | 22764 Normandy Ave, Eastpointe, MI 48021-1854 | 2016-07-07 |
| 1639532765 | Tracey Jackson | Social Worker | 5937 Larchwood Ave, Philadelphia, PA 19143-1115 | 2016-04-05 |
| 1609063882 | Tracey Monique Jackson | Registered Nurse | 23 Flanders St, Rochester, NY 14619-1705 | 2007-10-01 |
| 1174948038 | Tracey Jackson | Occupational Therapist | 4801 Springfield St, Dayton, OH 45431-1084 | 2014-02-28 |
| 1861643389 | Tracey Ann Jackson | Counselor | 1547 Parkway Ste 100, Greenwood, SC 29646-4081 | 2008-10-02 |
| 1487803870 | Tracey D Jackson | Pharmacist | 1000 Locust St, Reno, NV 89502-2597 | 2008-09-10 |
| 1902074545 | Tracey Jackson | Counselor | 2814 W 2nd St, Wilmington, DE 19805-1807 | 2008-02-18 |
| 1215121835 | Tracey Jackson | Physician Assistant | 320 E North Ave, Pittsburgh, PA 15212-4756 | 2007-08-28 |
| 1558486803 | Tracey L Jackson | Counselor | 4612 Roosevelt Ave, Sacramento, CA 95820 | 2007-03-19 |
| 1902808868 | Tracey L Jackson | Nurse Anesthetist, Certified Registered | 615 S New Ballas Rd, Sjmmc Dept of Anes, Saint Louis, MO 63141-8221 | 2005-08-11 |
| Street Address |
820 N PLANKINTON AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53203-1802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982654091 | Aids Resource Center of Wisconsin, Inc. | Case Management | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2006-05-11 |
| 1508427139 | Leilah Korbines | Dietitian, Registered | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2019-06-25 |
| 1982260097 | Hailey Elizabeth Keeser | Pharmacist | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2019-05-14 |
| 1003334350 | Jonathan Weimer | Nurse Practitioner | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2017-09-07 |
| 1265982490 | Brian Nguyen | Pharmacist | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2016-10-12 |
| 1821458746 | Carolyn Wesolowski | Case Manager/Care Coordinator | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2016-03-04 |
| 1851751796 | Maria Huerta | Case Manager/Care Coordinator | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2016-03-04 |
| 1689034522 | Hannah Fogarty | Case Manager/Care Coordinator | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2016-03-04 |
| 1184084014 | Jessica Cushion | Case Manager/Care Coordinator | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2016-03-04 |
| 1396105227 | Maria Selig | Case Manager/Care Coordinator | 820 N Plankinton Ave, Milwaukee, WI 53203-1802 | 2016-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013463272 | Kameela Jackson | Registered Nurse | 606 E Juneaue Ave. 511812, Milwaukee, WI 53203 | 2016-08-28 |
| 1528239928 | Christina Marie Sauber | Physical Therapy Assistant | 111 W. Michigan Street, Milwaukee, WI 53203 | 2008-03-13 |
| 1720273493 | Michelle Lynn Vogel | Speech-Language Pathologist | 111 West Michigan St, Prostep/extendicare Healthservices, Milwaukee, WI 53203 | 2007-09-06 |
| 1265572564 | Eye Care of Wisconsin, Inc | Health Maintenance Organization | 740 North Plankinton Ave, #730b, Milwaukee, WI 53203 | 2007-02-07 |
| 1073687349 | Riverwalk Psychotherapy Associates, LLC | Social Worker | 1110 N. Old World Third St., Suite 401, Milwaukee, WI 53203 | 2006-11-20 |
| 1144793423 | Carissa Deanna Basile | Behavioral Analyst | 525 N 6th St, Milwaukee, WI 53203 | 2019-01-09 |
| 1275975807 | Sandra Eiler | Counselor | 633 W Wisconsin Ave, Suite 1810, Milwaukee, WI 53203 | 2013-07-24 |
| 1154693331 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 826 N Plankinton Ave Ste 100, Milwaukee, WI 53203 | 2012-02-02 |
| 1821277310 | Rosalie C Mackay | Community Health Worker | 111 W Michigan St, Prostep/extendicare Health Services, Milwaukee, WI 53203 | 2007-10-31 |
| 1255488292 | Melinda Hughes | Counselor | 1110 N Old World 3rd St, Suite 401, Milwaukee, WI 53203-1100 | 2007-01-04 |
| Find all providers in zip 53203 | ||||
| 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 |
|---|---|---|---|---|
| 1750996518 | Prevale S Mclin | Case Manager/Care Coordinator | 6096 N Hopkins St, Milwaukee, WI 53209-3558 | 2020-09-09 |
| 1538771712 | Monet Smith | Case Manager/Care Coordinator | 5831 W Burleigh St, Milwaukee, WI 53210-1517 | 2020-08-19 |
| 1174131973 | Dakisha Delaney | Case Manager/Care Coordinator | 2456 N 41st St, Milwaukee, WI 53210-2932 | 2020-07-17 |
| 1528686342 | Dejuana Farmer | Case Manager/Care Coordinator | 2868 N 41st St, Milwaukee, WI 53210-1810 | 2020-07-08 |
| 1720600836 | Tiny Miracles Doula Services Inc | Case Manager/Care Coordinator | 4738 W Lisbon Ave Ste 7, Milwaukee, WI 53208-1127 | 2020-05-12 |
| 1700410362 | Annie P Robinson | Case Manager/Care Coordinator | 2142 N 15th St, Milwaukee, WI 53205-1209 | 2020-02-23 |
| 1932732682 | Austiana Jackson | Case Manager/Care Coordinator | 4555 N 65th St, Milwaukee, WI 53218-5508 | 2020-02-20 |
| 1891334132 | Blessed Hands Prenatal Services | Case Manager/Care Coordinator | 3755 N 49th St, Milwaukee, WI 53216-2912 | 2020-01-03 |
| 1730725656 | Lekecia Ferguson | Case Manager/Care Coordinator | 7970 W Glendbrook Rd, Milwaukee, WI 53223 | 2019-11-26 |
| 1124663299 | C Renee Consulting and Management Group | Case Manager/Care Coordinator | 6090 N 35th St Ste 204, Milwaukee, WI 53209-3602 | 2019-11-13 |
| Find all providers in MILWAUKEE | ||||
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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.