JACLYN SUZANNE GORDON (NPI# 1720698012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720698012 |
| Entity Type | Individual |
| Full Name | JACLYN SUZANNE GORDON |
| Practice Address |
110 Reading Ave Jonesville MI 49250-1136 |
| Practice Telephone | 5178492330 |
| Mailing Telephone | 5178492330 |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-08-03 |
| 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 | ||
| N | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598158453 | Jaclyn D Gordon | Physician Assistant | 115 Lincoln St, Framingham, MA 01702-6358 | 2015-03-16 |
| Street Address |
110 READING AVE |
| City | JONESVILLE |
| State | MI |
| Zip Code | 49250-1136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851580831 | Mccullough Vargas and Associates Inc | Community/Behavioral Health | 110 Reading Ave, Jonesville, MI 49250-1136 | 2007-10-16 |
| 1477150621 | Matthew Studer | Peer Specialist | 110 Reading Ave, Jonesville, MI 49250-1136 | 2020-10-01 |
| 1376140525 | Christian Riske | Peer Specialist | 110 Reading Ave, Jonesville, MI 49250-1136 | 2020-10-01 |
| 1629603444 | Kevin Vanbuskirk | Counselor | 110 Reading Ave, Jonesville, MI 49250-1136 | 2020-03-12 |
| 1992363378 | Philip Monahan | Counselor | 110 Reading Ave, Jonesville, MI 49250-1136 | 2019-05-31 |
| 1659939247 | Nathan Bones | Peer Specialist | 110 Reading Ave, Jonesville, MI 49250-1136 | 2019-05-30 |
| 1053880179 | Amber Mariah Reynolds | Counselor | 110 Reading Ave, Jonesville, MI 49250-1136 | 2018-11-19 |
| 1982173159 | Christine Wright | Social Worker | 110 Reading Ave, Jonesville, MI 49250-1136 | 2018-11-17 |
| 1801364336 | Charles Clemons | Peer Specialist | 110 Reading Ave, Jonesville, MI 49250-1136 | 2018-11-02 |
| 1659864304 | James Edward Carlin | Counselor | 110 Reading Ave, Jonesville, MI 49250-1136 | 2018-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649561697 | Community Prevention and Treatment Services | Substance Abuse Rehabilitation Facility | 401 W. Chicago Rd., Jonesville, MI 49250 | 2011-04-26 |
| 1427123413 | Sharon L Dow | Dentist | 211 Harley St, Jonesville, MI 49250 | 2006-11-22 |
| 1992889588 | David J Betz | Dentist | 211 Harley, Jonesville, MI 49250 | 2006-10-24 |
| 1225417975 | William W Adams | Dentist | 211 Harley St, Jonesville, MI 49250 | 2015-05-28 |
| 1285881532 | S and S Dow Management Co LLC | Dentist | 211 Harley St, Jonesville, MI 49250 | 2008-08-19 |
| 1538220249 | Sharon L Dow Dds | Dentist | 211 Harley St, Jonesville, MI 49250 | 2006-12-13 |
| 1770035578 | Mccullough, Vargas, & Associates, Inc. | Community/Behavioral Health | 101 Reading Ave, Jonesville, MI 49250-0000 | 2016-10-27 |
| 1275778946 | Primary Care Associates of Jonesville LLC | Clinic/Center | 100 E Chicago Street, Jonesville, MI 49250-0000 | 2008-12-10 |
| 1639166424 | Nash Drugs Inc | Pharmacy | 237 E Chicago St, Jonesville, MI 49250-1002 | 2005-10-05 |
| 1386013191 | Paul Landini | Pharmacist | 237 E Chicago St, Jonesville, MI 49250-1002 | 2015-09-22 |
| Find all providers in zip 49250 | ||||
| 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 |
|---|---|---|---|---|
| 1548738859 | Tracy Johnston | Case Manager/Care Coordinator | 15033 Highway 8, Jonesville, LA 71343-3903 | 2018-11-05 |
| 1306323472 | Jackuelyne Parker | Case Manager/Care Coordinator | 505 Mound St, Jonesville, LA 71343 | 2018-07-23 |
| 1275671539 | Melinda Jane Woliver | Case Manager/Care Coordinator | Rt 3, Box 1700 Lee County Behavioral Health Services, Jonesville, VA 24263 | 2007-02-01 |
| 1265949663 | Patricia King | Case Manager/Care Coordinator | 110 Reading Ave, Jonesville, MI 49250-1136 | 2018-01-08 |
| 1720218589 | Linda Anderson | Case Manager/Care Coordinator | 34084 Wilderness Rd, Jonesville, VA 24263-7899 | 2009-07-15 |
| 1881732147 | Tonia Lynn Lewis | Case Manager/Care Coordinator | Rt 3 Box 1700, Lee County Behavioral Health Services, Jonesville, VA 24263 | 2007-02-01 |
| 1437297710 | Debbie Ann Mcconnell | Case Manager/Care Coordinator | Route 3 Box 1700, Lee County Behavioral Health Services, Jonesville, VA 24263 | 2007-02-01 |
| 1902944267 | Stephanie Ellen Ramsey | Case Manager/Care Coordinator | Rt 3 Box 1700, Jonesville, VA 24263 | 2007-02-01 |
| 1497893796 | Susan Weeks Soden | Case Manager/Care Coordinator | Route 3 Box 1700, Lee County Behavioral Health Svces, Jonesville, VA 24263 | 2007-02-01 |
| 1407994775 | Shannon Renee Moles | Case Manager/Care Coordinator | Rt 3 Box 1700, Lee County Behavioral Health Services, Jonesville, VA 24263 | 2007-02-01 |
| Find all providers in JONESVILLE | ||||
| City | JONESVILLE |
| Zip Code | 49250 |
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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.