MR. JACK JOHNSON AVERY III


Address: 9150 Imperial Hwy Rm P-31, Downey, CA 90242-2835
Phone: 5629403694

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 171M00000X Case Manager/Care Coordinator Other Service Providers

Other Providers JACK AVERY

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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

Office Location

Street Address 9150 IMPERIAL HWY RM P-31
City DOWNEY
State CA
Zip Code 90242-2835

Providers in the same location

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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Providers in the same zip code

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 Information

Taxonomy Code 171M00000X
Grouping Other Service Providers
Classification Case Manager/Care Coordinator

Taxonomy Definition

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]

Providers in the same taxonomy and city

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
Find all providers in DOWNEY

Competitor

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City DOWNEY
Zip Code 90242

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Dataset Information

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.

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