MS. JILL ANN STARK (NPI# 1376813675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376813675 |
| Entity Type | Individual |
| Full Name | MS. JILL ANN STARK |
| Practice Address |
2785 College Rd Fairbanks AK 99709-3751 |
| Mailing Address |
1825 Marika Rd Fairbanks AK 99709-5521 |
| Practice Telephone | 9073741844 |
| Practice Fax Number | 9073741877 |
| Mailing Telephone | 9074740890 |
| Mailing Fax Number | 9074743621 |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MH3237 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538371786 | Jill Susan Stark II | Developmental Therapist | 2293 Avalon Dr, Buffalo Grove, IL 60089-4688 | 2007-05-03 |
| Street Address |
2785 COLLEGE RD |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99709-3751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801104203 | Kevin Thomas Ray | Counselor | 2785 College Rd, Fairbanks, AK 99709-3751 | 2010-09-20 |
| 1629348651 | David Charles Boyens II | Case Manager/Care Coordinator | 2785 College Rd, Fairbanks, AK 99709-3751 | 2012-01-06 |
| 1508136789 | Ron L Foster | Case Manager/Care Coordinator | 2785 College Rd, Fairbanks, AK 99709-3751 | 2012-01-05 |
| 1891065108 | Kathie C Elmore | Case Manager/Care Coordinator | 2785 College Rd, Fairbanks, AK 99709-3751 | 2012-01-03 |
| 1841560315 | Lucy Ellen Smyth | Case Manager/Care Coordinator | 2785 College Rd, Fairbanks, AK 99709-3751 | 2011-12-30 |
| 1487923975 | Cheryl L. Williams | Case Manager/Care Coordinator | 2785 College Rd, Fairbanks, AK 99709-3751 | 2011-12-29 |
| 1962703801 | Karin Michelle Mensing | Counselor | 2785 College Rd, Fairbanks, AK 99709-3751 | 2010-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946810 | Beacon Monitoring Professional Services | Technician, Other | 745 Staffordshire Rd, Fairbanks, AK 99709 | 2020-09-10 |
| 1235629544 | Fairbanks Healing Space | Health Educator | 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 | 2018-05-11 |
| 1609395409 | Shawn K Goggins | Counselor | 1423 Peger Road, Fairbanks, AK 99709 | 2017-09-12 |
| 1710433347 | Jay Titus | Technician/Technologist | 2884 Marina Drive, Fairbanks, AK 99709 | 2016-09-01 |
| 1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
| 1629407325 | Diane Louise Mitchell | Nurse Practitioner | 4650 Harvard Cir, Fairbanks, AK 99709 | 2013-11-04 |
| 1407147929 | Christina Martz | Counselor | 1270 Summet Drive, Fairbanks, AK 99709 | 2011-05-02 |
| 1255652285 | Surgery Center of Fairbanks LLC | Clinic/Center | 2310 Peger Road, Fairbanks, AK 99709 | 2010-06-14 |
| 1962661835 | John Leo Hughes Jr Jr. | Dentist | 3437 Airport Way, Suite 205, Fairbanks, AL 99709 | 2008-06-05 |
| 1508042417 | Katherine E Johnson, Md PC | Ophthalmology | 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 | 2008-01-10 |
| Find all providers in zip 99709 | ||||
| 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 |
|---|---|---|---|---|
| 1922665132 | Yelena Petkova | Case Manager/Care Coordinator | 270 Fairhill Rd, Fairbanks, AK 99712-1614 | 2019-05-22 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1528624699 | Christy Ann Herman | Case Manager/Care Coordinator | 661 Fordham Dr, Fairbanks, AK 99709-6763 | 2019-05-14 |
| 1144795055 | Debbie A Clarke | Case Manager/Care Coordinator | 1173 Sunset Dr, Fairbanks, AK 99709-4745 | 2018-10-06 |
| 1679938096 | Rachel Pleasants | Case Manager/Care Coordinator | 1422 Hampstead Ave, Fairbanks, AK 99701-2729 | 2015-12-30 |
| 1790039824 | Tracy Marie Rodden-larson | Case Manager/Care Coordinator | 60 Hall St, Fairbanks, AK 99701-4828 | 2012-10-26 |
| 1700163565 | Anita M Rodriguez | Case Manager/Care Coordinator | 3407 Airport Way, Fairbanks, AK 99709-4761 | 2011-11-08 |
| 1295045508 | Kelly Eggleston | Case Manager/Care Coordinator | 764 Adventure Road, Fairbanks, AK 99712 | 2010-10-20 |
| 1093030025 | Robin Jane Boggs | Case Manager/Care Coordinator | 3875 Geist Rd Ste E312, Fairbanks, AK 99709-3549 | 2010-04-01 |
| 1659601771 | Georgia Reynolds | Case Manager/Care Coordinator | 526 Gaffney Rd, Suite 100, Fairbanks, AK 99701-4914 | 2010-01-12 |
| Find all providers in FAIRBANKS | ||||
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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.