KENDALL BROCAVICH (NPI# 1447851670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447851670 |
| Entity Type | Individual |
| Full Name | KENDALL BROCAVICH |
| Practice Address |
397 Blunk St Plymouth MI 48170-3752 |
| Practice Telephone | 2489825630 |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |
| Gender Code | F |
| 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 |
397 BLUNK ST |
| City | PLYMOUTH |
| State | MI |
| Zip Code | 48170-3752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611734 | Brightside Medical of Michigan, P.C. | Psychiatry & Neurology | Telemedicine Services Only / No Physical Office, Telemedicine Services Only / No Physical, MI 48170 | 2020-02-18 |
| 1265075279 | Mast Enterprises | Home Health | 40800 Five Mile Rd Ste C, Plymouth, MI 48170 | 2019-10-22 |
| 1003470964 | Smiley Private Homecare LLC | Technician, Pathology | 1098 Ann Arbor Rd #249, Plymouth, MI 48170 | 2019-04-26 |
| 1275003832 | Atsalis Dental Excellence | Dentist | 690 South Main St, Plymouth, MI 48170 | 2018-11-27 |
| 1275003808 | Danielle Cefalo | Speech-Language Pathologist | 801 W. Ann Arbor Trail Suite 220, Plymouth, MI 48170 | 2018-11-27 |
| 1962987966 | Mindful Wellness Counseling, LLC | Social Worker | 9266 Northern Ave, Plymouth, MI 48170 | 2018-09-26 |
| 1972094027 | Plymouth Urgent Care Walk-in Clinic LLC | Clinic/Center | 1498 S Sheldon Rd, Plymouth, MI 48170 | 2018-05-24 |
| 1356843791 | Polaris Pharmacy Services of Michigan, LLC | Pharmacy | 9131 General Court, Plymouth, MI 48170 | 2018-03-01 |
| 1528569787 | Alcona Citizens for Health Inc | Clinic/Center | 101 S Union St Unit 101, Plymouth, MI 48170 | 2018-02-23 |
| 1073029484 | Holly Ann Haase | Technician/Technologist | 650 Church St, Plymouth, MI 48170 | 2017-12-20 |
| Find all providers in zip 48170 | ||||
| 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 |
|---|---|---|---|---|
| 1417445289 | Susan Ann Adams | Case Manager/Care Coordinator | 260 Ship Pond Rd, Plymouth, MA 02360 | 2018-04-27 |
| 1407308562 | Sharon Williams | Case Manager/Care Coordinator | 1 S Spooner St, Plymouth, MA 02360-4446 | 2016-10-25 |
| 1265844864 | Nelda Burk | Case Manager/Care Coordinator | 485 Maria Dr, Plymouth, MI 48170-1805 | 2014-05-30 |
| 1760814008 | Kathryn Mary Pearch | Case Manager/Care Coordinator | 9318 Marilyn Ave, Plymouth, MI 48170-4612 | 2013-08-08 |
| 1407114416 | Dawn Decoste | Case Manager/Care Coordinator | 5 Tananger Rd, Plymouth, MA 02360-2655 | 2012-04-26 |
| 1821360967 | Kristine Marie Van Ess | Case Manager/Care Coordinator | 7135 Rocky Knoll Pkwy, Plymouth, WI 53073 | 2012-02-06 |
| 1043529993 | Eric J Tengberg | Case Manager/Care Coordinator | 29 Federal Furnace Rd, Plymouth, MA 02360-4658 | 2010-09-27 |
| 1700115516 | Kellie Ann Gately | Case Manager/Care Coordinator | 111 Settler Rd, Plymouth, MA 02360-2959 | 2009-12-08 |
| 1003099391 | Meredith Eileen Ramos | Case Manager/Care Coordinator | 27 Worrall Rd, Plymouth, MA 02360-5251 | 2007-12-10 |
| 1336703982 | Signify Health Medical Associates of Michigan, P.C. | Case Manager/Care Coordinator | 40600 Ann Arbor Rd E Ste 201, Plymouth, MI 48170-4675 | 2019-04-30 |
| Find all providers in PLYMOUTH | ||||
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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.