SIMONE JACKSON (NPI# 1619483013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619483013 |
| Entity Type | Individual |
| Full Name | SIMONE JACKSON |
| Practice Address |
8745 County Road 9 S Alamosa CO 81101-9610 |
| Practice Telephone | 7195893671 |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2017-12-20 |
| 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 |
|---|---|---|---|---|
| 1740846328 | Simone Jackson | Physical Therapist | 70 Pleasant Hill Ln, Tamarac, FL 33319-2442 | 2019-05-19 |
| 1134644396 | Simone Jackson | Nurse Practitioner | 9029 S Pecos Rd Ste 2800, Henderson, NV 89074-7199 | 2017-08-09 |
| 1871041657 | Simone D Jackson | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2016-09-21 |
| 1437519394 | Simone Jackson | Social Worker | 3491 Gandy Blvd N, #201, Pinellas Park, FL 33781-2658 | 2016-03-03 |
| 1205214988 | Simone Rene Jackson | Counselor | 1044 Gilbert St, Flint, MI 48532-3527 | 2015-05-13 |
| Street Address |
8745 COUNTY ROAD 9 S |
| City | ALAMOSA |
| State | CO |
| Zip Code | 81101-9610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063406999 | San Luis Valley Community Mental Health Center | Counselor | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2005-09-07 |
| 1356955637 | San Luis Valley Community Mental Health Center | Clinic/Center | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2020-09-03 |
| 1225647712 | Matthew Richard Harris | Counselor | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2020-07-30 |
| 1811517733 | Desiree Kamilah Sierra | Licensed Practical Nurse | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2020-04-21 |
| 1235774324 | Robyn M Hindes | Licensed Practical Nurse | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2019-11-12 |
| 1790258622 | Frances Mestas | Licensed Practical Nurse | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2019-01-03 |
| 1053889246 | Jessica Elizabeth Chacon | Counselor | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-11-06 |
| 1912472218 | Marie B Duran | Licensed Practical Nurse | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-10-12 |
| 1760957062 | Ellyn Tia Pleiman | Counselor | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-10-12 |
| 1104391408 | Raquel M Rhoads | Counselor | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-10-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962909325 | Tiffanie Nicole Hoover | Nurse Practitioner | Slv Health, 106 Blanca Ave, Alamosa, CO 81101 | 2018-04-11 |
| 1629503669 | Early Oral Health Interception LLC | Dental Hygienist | 235 Carson Avenue, Alamosa, CO 81101 | 2017-04-27 |
| 1477917391 | Mary Sawyer | Nurse Practitioner | San Luis Valley Health106 Blanca Ave, Alamosa, CO 81101 | 2016-04-06 |
| 1508221276 | Kendal W Humes | Counselor | 1460 W 8th Street, Unit 13, Alamosa, CO 81101 | 2015-12-23 |
| 1689096422 | Julia Toczek | Counselor | 8745 County Road 9s, Alamosa, CO 81101 | 2014-01-14 |
| 1275883365 | Michelle Marie Craver | Counselor | 8745 County Road 9 South, Alamosa, CO 81101 | 2012-09-15 |
| 1417193079 | Slv Eye Docs, LLC | Optometrist | 706 Del Sol Dr, Alamosa, CO 81101 | 2008-12-31 |
| 1770753154 | Huh Inc | Hearing Instrument Specialist | 2101 Main St., Ste C Ears 2 U Hearing Aid Services, Alamosa, CO 81101 | 2008-03-03 |
| 1215139613 | Valley-wide Health System, Inc. | Pharmacist | 1710 1st Street, Alamosa, CO 81101 | 2007-06-05 |
| 1821204116 | Valerie Stephanie Gurule-duran | Counselor | 8745 Cr 9 South, Alamosa, CO 81101 | 2007-05-15 |
| Find all providers in zip 81101 | ||||
| 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 |
|---|---|---|---|---|
| 1578038873 | Emily Valdez | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-10-12 |
| 1770062259 | Alisa Owen Stuwe | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-08-07 |
| 1205329984 | Brittney R Siler | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-06-07 |
| 1013409614 | Charla Rae Cooley | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-05-31 |
| 1285121848 | Vennessa Martinez | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-04-19 |
| 1114424686 | Ashley Sasser | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-04-10 |
| 1689174336 | Karina Duarte | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-02-20 |
| 1487154449 | Erica Reanne Ulibarri | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-02-16 |
| 1982103578 | Shannon Powers | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2018-02-08 |
| 1386163525 | Lisha Duran | Case Manager/Care Coordinator | 8745 County Road 9 S, Alamosa, CO 81101-9610 | 2017-09-19 |
| Find all providers in ALAMOSA | ||||
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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.