CLAYTON JEROME KNUPP (NPI# 1366925067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366925067 |
| Entity Type | Individual |
| Full Name | CLAYTON JEROME KNUPP |
| Practice Address |
490 Broadmoor Dr Brinkley AR 72021-2057 |
| Mailing Address |
2707 Browns Ln Jonesboro AR 72401-7213 |
| Practice Telephone | 8707343202 |
| Practice Fax Number | 8707343299 |
| Mailing Telephone | 8709724939 |
| Mailing Fax Number | 8709724911 |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-10 |
| 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 |
490 BROADMOOR DR |
| City | BRINKLEY |
| State | AR |
| Zip Code | 72021-2057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639198229 | Sherry Armstrong | Clinical Nurse Specialist | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2006-07-18 |
| 1760040885 | Brenda G St. Clair | Licensed Practical Nurse | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2019-06-04 |
| 1285136366 | Marla Denise Lane | Case Manager/Care Coordinator | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2018-03-05 |
| 1548775679 | Christina Lashae James | Case Manager/Care Coordinator | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2017-12-12 |
| 1225554942 | Jennifer Rose Hodges | Case Manager/Care Coordinator | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2017-08-15 |
| 1447570239 | Northeast Arkansas Community Mental Health Center | Counselor | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2010-06-03 |
| 1871737502 | Johnathan Clyde Simpson | Social Worker | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2009-04-24 |
| 1417108846 | Counseling Services of Eastern Arkansas | Counselor | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2008-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386293041 | Brinkley Family Pharmacy | Pharmacy | 1415 Pinecrest Suite 8, Brinkley, AR 72021 | 2019-09-05 |
| 1225278633 | Adrian Cornelio, P.a. | Physical Therapist | 1116 N New York St Extension, Brinkley, AR 72021 | 2009-02-25 |
| 1124219605 | Joanne Jackson | Technician | 412 S Chaney Ave, Brinkley, AR 72021 | 2007-08-08 |
| 1518007947 | Home Care Medical System Inc | Durable Medical Equipment & Medical Supplies | 105 South New Orleans Avenue, Brinkley, AR 72021 | 2007-02-07 |
| 1962500215 | Joseph S Barker | Dentist | 206 North Main, Brinkley, AR 72021 | 2006-09-20 |
| 1649200890 | Southern Paramedic Service Inc | Ambulance | 210 N New Orleans Street, Brinkley, AR 72021 | 2006-07-04 |
| 1245406107 | Counseling Consultants | Clinic/Center | 120 South Main Street, Brinkley, AR 72021 | 2008-05-01 |
| 1326033515 | Medi-mart Pharmacy Inc | Pharmacy | 1415 Pinecrest Shopping Ctr, Brinkley, AR 72021-2000 | 2005-09-14 |
| 1801025549 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 1415 Pinecrest Shopping Ctr, Brinkley, AR 72021-2000 | 2009-07-02 |
| 1275974206 | Sam R Curry | Pharmacist | 1311 N Charlyne Ave, Brinkley, AR 72021-2001 | 2013-07-06 |
| Find all providers in zip 72021 | ||||
| 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 |
|---|---|---|---|---|
| 1851614754 | Stewart Franklin Hoyle | Case Manager/Care Coordinator | 229 W Cypress St, Brinkley, AR 72021-2801 | 2010-03-05 |
| 1285136366 | Marla Denise Lane | Case Manager/Care Coordinator | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2018-03-05 |
| 1548775679 | Christina Lashae James | Case Manager/Care Coordinator | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2017-12-12 |
| 1225554942 | Jennifer Rose Hodges | Case Manager/Care Coordinator | 490 Broadmoor Dr, Brinkley, AR 72021-2057 | 2017-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386256014 | Jessica Marie Hazelip | Case Manager/Care Coordinator | 2126 N 1st St, Jacksonville, AR 72076-2870 | 2020-08-24 |
| 1619587383 | First Choice Care Management Consulting LLC | Case Manager/Care Coordinator | 155 Leatherwood Loop, Hot Springs, AR 71901-9580 | 2020-08-06 |
| 1649889775 | Haley Kathryn Mehan | Case Manager/Care Coordinator | 109 2nd Ave Sw Apt A, Gravette, AR 72736-6009 | 2020-07-24 |
| 1114535838 | Amber Michelle Cansler | Case Manager/Care Coordinator | 637 Ar-8, Amity, AR 71921 | 2020-07-20 |
| 1649807595 | Vickie Carter | Case Manager/Care Coordinator | 1704 Highway 49 West, Trumann, AR 72472-2029 | 2020-03-23 |
| 1619501087 | 1 Source Senior Care | Case Manager/Care Coordinator | 1820 Shelby Ln, Fayetteville, AR 72704-5255 | 2020-02-25 |
| 1194356964 | Yanira Harper | Case Manager/Care Coordinator | 204 Martha Ln Apt B, Gurdon, AR 71743-2210 | 2020-01-30 |
| 1326679473 | Megan Thomas | Case Manager/Care Coordinator | 3715 N Business Dr Ste 201, Fayetteville, AR 72703-5288 | 2020-01-28 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1619516051 | Kyjione King | Case Manager/Care Coordinator | 721 S Gee St Ste A, Jonesboro, AR 72401-3308 | 2020-01-02 |
| Find all providers with the same taxonomy | ||||
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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.