ALISA D WALLACE (NPI# 1669936621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669936621 |
| Entity Type | Individual |
| Full Name | ALISA D WALLACE |
| Practice Address |
803 Columbia Ave Monticello KY 42633 |
| Mailing Address |
130 Southern School Rd Somerset KY 42501-3223 |
| Practice Telephone | 6063489318 |
| Mailing Telephone | 6066794782 |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2019-01-24 |
| 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 |
| Street Address |
803 COLUMBIA AVE |
| City | MONTICELLO |
| State | KY |
| Zip Code | 42633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457963431 | Morgan Dishman | Pharmacist | 126 Franklin Dr, Monticello, KY 42633 | 2020-08-20 |
| 1942847686 | Burgess Drug Store Inc. | Pharmacy | 1 S. Creek Dr., Ste. #122, Monticello, KY 42633 | 2019-12-02 |
| 1639729460 | Lake Cumberland Therapy Center, Inc. | Developmental Therapist | 153 High Street, Monticello, KY 42633 | 2019-09-13 |
| 1053964965 | Faith Healthcare Inc | Nurse Practitioner | 126 Franklin Drive, Monticello, KY 42633 | 2019-07-19 |
| 1194232207 | Jacob Dudley Coffey | Nurse Practitioner | 1 S Creek Dr Ste 102606, Monticello, KY 42633 | 2018-01-10 |
| 1245581578 | Joleen Nyesa Levering | Pharmacist | 1078 North Main Streeet, Monticello, KY 42633 | 2012-09-26 |
| 1194085977 | Steven M Tallent II | Dentist | 1225 N. Main St., Brummett Cosmetic and Family Dentistry, Monticello, KY 42633 | 2012-05-25 |
| 1245376243 | Diagnostic Radiology of London | Specialist | 1455 E Hwy 90 By-pass Unit #4, Monticello, KY 42633 | 2007-01-29 |
| 1639241433 | Hicks Enterprises of Monticello, LLC | Nursing Facility/Intermediate Care Facility | 1801 W. Hwy. 90 By-pass, Monticello, KY 42633 | 2006-11-15 |
| 1720160526 | Cumberland Gastroenterology, P.s.c. | Nurse Practitioner | 1 Southcreek Drive, Monticello, KY 42633 | 2006-10-20 |
| Find all providers in zip 42633 | ||||
| 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 |
|---|---|---|---|---|
| 1255861175 | Casey Smith | Case Manager/Care Coordinator | 600 Highway 425 N Ste B, Monticello, AR 71655-4020 | 2017-06-13 |
| 1861814899 | Carla Candy Groce | Case Manager/Care Coordinator | 735 W Columbia Ave, Monticello, KY 42633-1627 | 2014-01-10 |
| 1285869552 | Hannah M Ransom | Case Manager/Care Coordinator | 1010 N Mulberry St, Monticello, FL 32344-1534 | 2009-05-15 |
| 1588783070 | Julie K Mcclellan | Case Manager/Care Coordinator | 301 Mary Linda St, Monticello, KY 42633-1027 | 2007-03-28 |
| 1861516163 | Jessica L Riddle | Case Manager/Care Coordinator | Rr 6 Box 1754, West Hwy. 90, Monticello, KY 42633-3507 | 2007-03-19 |
| 1518583293 | Katy Streeter | Case Manager/Care Coordinator | 790 Roberts Dr, Monticello, AR 71655-5723 | 2020-06-18 |
| 1356967004 | Minerva Huante | Case Manager/Care Coordinator | 139c E Jackson Ave, Monticello, AR 71655-4933 | 2020-06-18 |
| 1558987248 | Shannon Davis | Case Manager/Care Coordinator | 790 Roberts Dr, Monticello, AR 71655-5723 | 2020-06-18 |
| 1841822970 | April Gardner | Case Manager/Care Coordinator | 790 Roberts Dr, Monticello, AR 71655-5723 | 2020-02-06 |
| 1316585011 | Dadrian Smith | Case Manager/Care Coordinator | 936 Jordan Dr, Monticello, AR 71655-5728 | 2019-12-13 |
| Find all providers in MONTICELLO | ||||
| City | MONTICELLO |
| Zip Code | 42633 |
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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.