MR. JACK JOHNSON AVERY III (NPI# 1730325986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730325986 |
Entity Type | Individual |
Full Name | MR. JACK JOHNSON AVERY III |
Practice Address |
9150 Imperial Hwy Rm P-31 Downey CA 90242-2835 |
Mailing Address |
8526 Grape St Los Angeles CA 90001-4134 |
Practice Telephone | 5629403694 |
Practice Fax Number | 5626587425 |
Mailing Telephone | 3235836401 |
Mailing Fax Number | 3235830189 |
Enumeration Date | 2008-12-17 |
Last Update Date | 2008-12-17 |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306930086 | Jack D. Avery | Speech-Language Pathologist | Minneapolis Vamc, 1 Veterans Drive, Minneapolis, MN 55417 | 2006-10-03 |
1962586370 | Jack H Avery | Radiologic Technologist | 3510 Ptarmigan Ln, Helena, MT 59602-0553 | 2006-10-24 |
Street Address |
9150 IMPERIAL HWY RM P-31 |
City | DOWNEY |
State | CA |
Zip Code | 90242-2835 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407065055 | Kasey Lamont Brown | Case Manager/Care Coordinator | 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835 | 2007-05-21 |
1699064519 | Juan Rueda | Case Manager/Care Coordinator | 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835 | 2011-03-31 |
1588962278 | Laco Probation Dept | Case Manager/Care Coordinator | 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835 | 2011-03-04 |
1093018442 | Phyllis Whitfield-scurlock | Case Manager/Care Coordinator | 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835 | 2010-12-07 |
1306146519 | Duke Shibata | Case Manager/Care Coordinator | 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835 | 2010-10-22 |
1114236957 | Carlos Vargas Jr. | Case Manager/Care Coordinator | 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835 | 2010-09-28 |
1356659312 | Terri L White | Case Manager/Care Coordinator | 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835 | 2010-09-23 |
1902118094 | Steven James Em | Case Manager/Care Coordinator | 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835 | 2010-07-06 |
1831413194 | Nila Jean Neat | Case Manager/Care Coordinator | 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835 | 2010-03-16 |
1891927646 | Willard Branch | Case Manager/Care Coordinator | 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835 | 2009-08-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972117182 | Andy Vo Osborne | Respiratory Therapist, Registered | 9333 E Imperial High Way, Downey, CA 90242 | 2020-09-04 |
1639783459 | Enrique Robles Soto | Behavior Technician | 12432 Bellflower Blvd., Downey, CA 90242 | 2020-08-31 |
1043842461 | Paul Yokoyama | Pharmacist | 9542 Dalen Street, Downey, CA 90242 | 2020-02-05 |
1639727837 | Demontay Deon High | Behavior Technician | 12342 Bellflower Blvd, Downey, CA 90242 | 2019-08-30 |
1467922328 | Nurisha Ficklin | Behavior Technician | 12342 Bellflower Blvd., Downey, CA 90242 | 2018-12-04 |
1235622358 | Marlene Castaneda | Occupational Therapist | 12555 Lakewood Blvd Ste D, Downey, CA 90242 | 2018-06-13 |
1942727383 | Arhtur Lozano | Non-emergency Medical Transport (VAN) | 13109 Woodruff Ave, Downey, CA 90242 | 2017-08-26 |
1336665983 | Laura E Del Val | Nurse Practitioner | 12207 Rives Ave, Downey, CA 90242 | 2017-08-16 |
1982127288 | Tiffany Chiyeko Yonemoto | Recreation Therapist | 7601 E. Imperial Hwy., Downey, CA 90242 | 2017-07-19 |
1265955504 | Julie Helgren | Recreation Therapist | 7601 E. Imperial Highway, Jpi Building Rm 1124, Downey, CA 90242 | 2017-07-19 |
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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 |
---|---|---|---|---|
1033749122 | Marilyn Pineda Gonzalez | Case Manager/Care Coordinator | 8043 1/2 Alameda St, Downey, CA 90242-2433 | 2020-01-17 |
1265945695 | Denise Garcia | Case Manager/Care Coordinator | 10000 Imperial Hwy Apt E310, Downey, CA 90242-3287 | 2017-11-07 |
1992217350 | Claudia Corona | Case Manager/Care Coordinator | 12617 Columbia Way Apt 7, Downey, CA 90242-4761 | 2017-10-25 |
1093177826 | Rashaad Grismore | Case Manager/Care Coordinator | 8025 3rd St, Apt J, Downey, CA 90241-3643 | 2016-03-22 |
1205271467 | Kent Malpartida | Case Manager/Care Coordinator | 9326 Orizaba Ave, Downey, CA 90240-2743 | 2013-05-01 |
1003050329 | Joi Noreen Nichols | Case Manager/Care Coordinator | 9150 East Imperial Highway, Room P-31, Downey, CA 90242 | 2009-04-30 |
1568606994 | Kicheko Sykes | Case Manager/Care Coordinator | 9150 Imperial Hwy # P-31, Downey, CA 90242-2835 | 2009-04-29 |
1134363757 | Felicia Lynn Dean | Case Manager/Care Coordinator | 9150 East Imperial Highway Room P-31, Downey, CA 90242 | 2009-04-27 |
1891933925 | Lyric Renee Dill | Case Manager/Care Coordinator | 9150 East Imperial Highway, Room P-31, Downey, CA 90242 | 2009-01-28 |
1265678296 | Jicela Soto | Case Manager/Care Coordinator | 9450 East Imperial Highway, Room P-31, Downey, CA 90242 | 2008-12-22 |
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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.