CRYSTAL KIDD (NPI# 1396268702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396268702 |
| Entity Type | Individual |
| Full Name | CRYSTAL KIDD |
| Practice Address |
3214 Winchester Benton AR 72015-2929 |
| Mailing Address |
3012 Turman Dr Jonesboro AR 72404-8998 |
| Practice Telephone | 5013266160 |
| Mailing Telephone | 8708190200 |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-18 |
| 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 |
|---|---|---|---|---|
| 1841544046 | Crystal Kidd | Technician | 19401 Northline Rd, Southgate, MI 48195-2277 | 2012-11-09 |
| Street Address |
3214 WINCHESTER |
| City | BENTON |
| State | AR |
| Zip Code | 72015-2929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790815041 | Julie M Christian | Speech-Language Pathologist | 3214 Winchester, Benton, AR 72015-2929 | 2007-03-06 |
| 1184222093 | Alix T Dyer | Occupational Therapist | 3214 Winchester, Benton, AR 72015-2929 | 2020-10-13 |
| 1770137275 | Jlm Ventures, Inc. | Clinic/Center | 3214 Winchester, Benton, AR 72015-2929 | 2019-08-01 |
| 1457905580 | Jlm Ventures, Inc. | Clinic/Center | 3214 Winchester, Benton, AR 72015-2929 | 2019-07-26 |
| 1245884378 | Jlm Ventures, Inc. | Occupational Therapist | 3214 Winchester, Benton, AR 72015-2929 | 2019-07-26 |
| 1831606235 | Dominique D Humphrey | Case Manager/Care Coordinator | 3214 Winchester, Benton, AR 72015-2929 | 2018-01-08 |
| 1386154334 | Sara N Knauf | Case Manager/Care Coordinator | 3214 Winchester, Benton, AR 72015-2929 | 2017-10-04 |
| 1114443280 | Victoria M Jones | Case Manager/Care Coordinator | 3214 Winchester, Benton, AR 72015-2929 | 2017-08-20 |
| 1962932293 | Sharon M Cooley | Case Manager/Care Coordinator | 3214 Winchester, Benton, AR 72015-2929 | 2017-06-19 |
| 1275061509 | Brandi Elaine Williams | Day Training/Habilitation Specialist | 3214 Winchester, Benton, AR 72015-2929 | 2017-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790343135 | Justin King | Case Manager/Care Coordinator | 1502 Mary Kay Blv6, Benton, AR 72015 | 2019-05-31 |
| 1790253326 | Seth Alexander Weisheit | Nurse Practitioner | 824 Military Road, Benton, AR 72015 | 2018-11-13 |
| 1396269627 | Abby G Sims | Speech-Language Pathologist | 3391 Peachtree Lane, Benton, AR 72015 | 2017-07-28 |
| 1225551278 | Jessica R Poe | Case Manager/Care Coordinator | 1502 Marykay Blvd, Benton, AR 72015 | 2017-07-21 |
| 1003357997 | Jamaal Langston | Case Manager/Care Coordinator | 1502 Mark Kay Blvd, Benton, AR 72015 | 2017-03-13 |
| 1881138550 | Shannon Gachot-ridgley | Counselor | 205 South Street Suite 3, Benton, AR 72015 | 2016-12-14 |
| 1295104578 | Excel Health of Haskell, Pllc | Clinical Nurse Specialist | 6029 Us Hwy 67, Haskell, AR 72015 | 2015-09-17 |
| 1528464054 | Kacey Jo Kiker | Nurse Practitioner | 620 W South St, Benton, AR 72015 | 2014-11-11 |
| 1700218252 | Jamie Brunt | Licensed Practical Nurse | 1718 Old Hot Springs Rd, Benton, AR 72015 | 2013-08-07 |
| 1760738942 | Kari J Richards | Physical Therapist | 5701 Springhill Rd, Bryant, AR 72015 | 2012-07-25 |
| Find all providers in zip 72015 | ||||
| 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 |
|---|---|---|---|---|
| 1508493404 | Nahum Prophet | Case Manager/Care Coordinator | 3610 Coleman Rd, Benton, LA 71006-9675 | 2020-03-23 |
| 1790343135 | Justin King | Case Manager/Care Coordinator | 1502 Mary Kay Blv6, Benton, AR 72015 | 2019-05-31 |
| 1225551278 | Jessica R Poe | Case Manager/Care Coordinator | 1502 Marykay Blvd, Benton, AR 72015 | 2017-07-21 |
| 1003357997 | Jamaal Langston | Case Manager/Care Coordinator | 1502 Mark Kay Blvd, Benton, AR 72015 | 2017-03-13 |
| 1265715072 | James Michael Bell | Case Manager/Care Coordinator | 1502 Mary Kaye Blvd, Benton, AR 72015-8909 | 2011-09-28 |
| 1386934206 | Debra A Davis | Case Manager/Care Coordinator | 6701 Hwy 67 S. Bldg 4, Benton, AR 72015 | 2011-04-12 |
| 1174833016 | Allen Cooper | Case Manager/Care Coordinator | 6701 Hwy 67 S Bldg 4, Benton, AR 72015 | 2010-10-13 |
| 1942454517 | Kathy James | Case Manager/Care Coordinator | 2270 Helmich Dr, Benton, AR 72019-8322 | 2008-11-10 |
| 1194994558 | Roshunda Denise Foreman | Case Manager/Care Coordinator | 307 E Sevier, Benton, AR 72015 | 2008-02-29 |
| 1609063791 | Sean Rock | Case Manager/Care Coordinator | 307 E Sevier St., Counseling Clinic Inc, Benton, AR 72015 | 2007-10-02 |
| Find all providers in BENTON | ||||
Please comment or provide details below to improve the information on CRYSTAL KIDD.
| 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.