MR. PHILIP MICHAEL BRADY (NPI# 1639236961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639236961 |
| Entity Type | Individual |
| Full Name | MR. PHILIP MICHAEL BRADY |
| Credential | CADC111 |
| Practice Address |
15957 Highway 101 S St. 6 Brookings OR 97415-8507 |
| Practice Telephone | 5414129060 |
| Practice Fax Number | 5414129339 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 210758 | 05 |
| Street Address |
15957 HIGHWAY 101 S ST. 6 |
| City | BROOKINGS |
| State | OR |
| Zip Code | 97415-8507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549575 | Christopher Scott Mayo Jr. | Denturist | 937 Chetco Ave Ste. B, Brookings, OR 97415 | 2020-02-12 |
| 1912564329 | Lori A Burkart | Speech-Language Pathologist | Curry Medical Ctr, 500 5th Street, Brookings, OR 97415 | 2019-05-21 |
| 1881144178 | Costa Clinical Psychology, LLC | Social Worker | 625 Spruce St., # 7666, Brookings, OR 97415 | 2016-10-11 |
| 1194173898 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 410 Maple St, Brookings, OR 97415 | 2016-06-03 |
| 1336595784 | Monica Shaw | Case Manager/Care Coordinator | 412 Alder, Brookings, OR 97415 | 2016-05-04 |
| 1639531437 | Ian Leonard | Behavioral Analyst | 450 Sb Chetco River Road, Brookings, OR 97415 | 2016-03-22 |
| 1518201151 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 210 Cove Lane, Brookings, OR 97415 | 2012-11-20 |
| 1699033365 | Sunlight Family Center, LLC | Clinic/Center | 604 Spruce Street, Brookings, OR 97415 | 2012-05-01 |
| 1649544784 | Oregon Coast Wellness Inc. | Clinic/Center | 648 Chetco Ave., Brookings, OR 97415 | 2012-03-07 |
| 1790072544 | Elizabeth A. Nation | Registered Nurse | 96343 Alder Ridge Road, Brookings, OR 97415 | 2011-06-30 |
| Find all providers in zip 97415 | ||||
| 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 |
|---|---|---|---|---|
| 1275085557 | Joshua Pruden | Case Manager/Care Coordinator | 602 Easy St Apt D, Brookings, OR 97415-9198 | 2016-11-02 |
| 1336595784 | Monica Shaw | Case Manager/Care Coordinator | 412 Alder, Brookings, OR 97415 | 2016-05-04 |
| 1518567718 | Evangeline Bruyere Grace | Case Manager/Care Coordinator | 615 5th St, Brookings, OR 97415-9199 | 2020-10-27 |
| 1477107118 | Michele Youngblood | Case Manager/Care Coordinator | 615 5th St, Brookings, OR 97415-9199 | 2019-07-31 |
| 1316501117 | Marissa J Mccrorey | Case Manager/Care Coordinator | 615 5th St, Brookings, OR 97415-9199 | 2019-04-26 |
| 1679037840 | Jenna Donovan | Case Manager/Care Coordinator | 615 5th St, Brookings, OR 97415-9199 | 2019-01-22 |
| 1558837351 | Julie Catherine Peterson | Case Manager/Care Coordinator | 615 5th St, Brookings, OR 97415-9199 | 2018-10-18 |
| 1285118034 | Joshua Rubio | Case Manager/Care Coordinator | 615 5th St, Brookings, OR 97415-9199 | 2018-09-18 |
| 1164900627 | Roddy Daniel Grace | Case Manager/Care Coordinator | 615 5th St, Brookings, OR 97415-9199 | 2018-08-06 |
| 1104328251 | Herman Brown Jr. | Case Manager/Care Coordinator | 615 5th St, Brookings, OR 97415-9199 | 2018-03-05 |
| Find all providers in BROOKINGS | ||||
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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.