ANGELA GAIL SOUTHERLAND (NPI# 1568641710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568641710 |
| Entity Type | Individual |
| Full Name | ANGELA GAIL SOUTHERLAND |
| Practice Address |
635 Vass Rd Raeford NC 28376-8412 |
| Practice Telephone | 9016706567 |
| Practice Fax Number | 9109042931 |
| Mailing Telephone | 9016706567 |
| Mailing Fax Number | 9109042931 |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
NC | Behavioral Health & Social Service Providers | |
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 10 | 05 | |
| NC | 34 | 05 | |
| NC | 347C00000 | 05 | |
| NC | 38 | 05 | |
| NC | 30 | 05 | |
| NC | 33 | 05 | |
| NC | 17 | 05 | |
| NC | 32 | 05 | |
| NC | 25 | 05 |
| Street Address |
635 VASS RD |
| City | RAEFORD |
| State | NC |
| Zip Code | 28376-8412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578185104 | Elite Supply Services, Inc. | Durable Medical Equipment & Medical Supplies | 2148 Bus-us 401, Raeford, NC 28376 | 2020-05-18 |
| 1205485695 | Brenda P Gregorio | Technician | 297 Gregorios Ln, Raeford, NC 28376 | 2019-09-09 |
| 1083197115 | Jennifer Picerno Bowyer | Nurse Practitioner | 929 Prospect Ave., Raeford, NC 28376 | 2018-09-14 |
| 1730694746 | Embassy Health Network | Counselor | 2148 Hwy 401 Business, Raeford, NC 28376 | 2017-12-13 |
| 1508398991 | Rockfish Pharmacy Inc | Pharmacy | 221 Flagstone Lane, Raeford, NC 28376 | 2017-04-03 |
| 1205281235 | William Fiebig | Nurse Practitioner | Hoke Hospital, 210 Medical Pavilion Drive, Raeford, NC 28376 | 2016-04-27 |
| 1306200647 | Tia Hart Community Recovery Program | Community/Behavioral Health | 2188 A Us 401 Business, Raeford, NC 28376 | 2016-04-13 |
| 1508240631 | Integrated Mental Health Services Agency Inc | Community/Behavioral Health | 2188-a Hwy 401 Business, Raeford, NC 28376 | 2015-07-18 |
| 1649658287 | Divine Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 320 Birch St, Raeford, NC 28376 | 2015-05-15 |
| 1992192298 | David Abdulhaqq | Counselor | 225 Aggies Lane, Raeford, NC 28376 | 2015-04-24 |
| Find all providers in zip 28376 | ||||
| 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 |
|---|---|---|---|---|
| 1033314463 | Annette Mcphatter Adams | Case Manager/Care Coordinator | 562 Sanders Rd, Raeford, NC 28376-8774 | 2007-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962000976 | Jamel Jones | Case Manager/Care Coordinator | 107 Davelin Pl, Goldsboro, NC 27530-4507 | 2020-10-12 |
| 1043821952 | Tracy Simerson | Case Manager/Care Coordinator | 9021 Duval Hill St, Raleigh, NC 27603-7522 | 2020-08-13 |
| 1104449164 | Yolanda Lynn Simpson | Case Manager/Care Coordinator | 559 Foster Rd, Yanceyville, NC 27379-8914 | 2020-05-26 |
| 1487274064 | J'aunie Y Mcrae-knight | Case Manager/Care Coordinator | 2037 Mlk Jr Dr, Greensboro, NC 27406-3314 | 2020-04-23 |
| 1144849597 | Barbara Denise Gaskins | Case Manager/Care Coordinator | 719 W 15th St Ste 727, Washington, NC 27889-3667 | 2020-04-15 |
| 1386273894 | Human Coalition | Case Manager/Care Coordinator | 4237 Louisburg Rd Ste 105, Raleigh, NC 27604-4348 | 2020-04-06 |
| 1275172298 | Kelsy Timas | Case Manager/Care Coordinator | 143 Skateway Dr, Fayetteville, NC 28304-2640 | 2019-12-23 |
| 1972153328 | Monida Fields | Case Manager/Care Coordinator | 4845 Ashley Park Ln Apt 220, Charlotte, NC 28210-4134 | 2019-09-18 |
| 1245884196 | Mildred Hopkins | Case Manager/Care Coordinator | 507 1st St, Spring Hope, NC 27882-9342 | 2019-07-30 |
| 1972167302 | Wfic | Case Manager/Care Coordinator | 811 Wesley Dr, Salisbury, NC 28146-2257 | 2019-05-01 |
| 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.