GAVIN MICHAEL TICE (NPI# 1760960017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760960017 |
| Entity Type | Individual |
| Full Name | GAVIN MICHAEL TICE |
| Practice Address |
525 Metro Pl N Ste 100 Dublin OH 43017-5343 |
| Practice Telephone | 6143398436 |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2910854 | 05 |
| Street Address |
525 METRO PL N STE 100 |
| City | DUBLIN |
| State | OH |
| Zip Code | 43017-5343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912436023 | Kirsten Leigh Crummel | Social Worker | 525 Metro Pl N Ste 100, Dublin, OH 43017-5343 | 2017-06-12 |
| 1497356059 | Adenike Adeyele | Licensed Practical Nurse | 525 Metro Pl N Ste 100, Dublin, OH 43017-5343 | 2020-11-02 |
| 1912507278 | Freowoini Menghsteab | Case Manager/Care Coordinator | 525 Metro Pl N Ste 100, Dublin, OH 43017-5343 | 2020-10-27 |
| 1497353577 | Megan Moses | Registered Nurse | 525 Metro Pl N Ste 100, Dublin, OH 43017-5343 | 2020-10-12 |
| 1730793357 | Regan Bennett | Case Manager/Care Coordinator | 525 Metro Pl N Ste 100, Dublin, OH 43017-5343 | 2020-09-01 |
| 1124638291 | Nathan Crummel | Case Manager/Care Coordinator | 525 Metro Pl N Ste 100, Dublin, OH 43017-5343 | 2020-08-04 |
| 1407466584 | Anita Issah | Case Manager/Care Coordinator | 525 Metro Pl N Ste 100, Dublin, OH 43017-5343 | 2020-08-04 |
| 1164032439 | Deritus Achaleke | Case Manager/Care Coordinator | 525 Metro Pl N Ste 100, Dublin, OH 43017-5343 | 2020-08-03 |
| 1275151789 | Leslie Althoff | Case Manager/Care Coordinator | 525 Metro Pl N Ste 100, Dublin, OH 43017-5343 | 2020-07-10 |
| 1487270732 | Stella Adepoju | Case Manager/Care Coordinator | 525 Metro Pl N Ste 100, Dublin, OH 43017-5343 | 2020-06-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770048894 | Teresa O'connell | Dermatology | Timeless Skin Solutions, 31 South High St, Dublin, OH 43017 | 2019-02-02 |
| 1356814560 | Trishaya Spain-austin | Behavior Technician | 545 Metro Place North, Suite 100, Dublin, OH 43017 | 2019-01-10 |
| 1669955902 | Tamara Moss | Occupational Therapist | 10516 Sawmill Road, Suite B, Dublin, OH 43017 | 2018-09-12 |
| 1548753692 | Complex Wound Consultant L.L.C. | Surgery | 5712 Southby Ct, Dublin, OH 43017 | 2018-06-13 |
| 1063916948 | Enabling Recovery LLC | Community/Behavioral Health | 5945 Sawmill Rd Ste B, Dublin, OH 43017 | 2018-03-23 |
| 1750898839 | Inner Health Chiropractic, Inc | Chiropractor | 220 West Bridge, Inner Health Chiropractic, Dublin, OH 43017 | 2018-01-10 |
| 1598274144 | Catherine Ann Albrecht | Case Manager/Care Coordinator | 525 Metro Place N., Dublin, OH 43017 | 2017-09-27 |
| 1346769338 | Rachel Mary Baldwin | Speech-Language Pathologist | 9892 Macdonald Dr., Dublin, OH 43017 | 2017-09-12 |
| 1629596275 | Julie Battaglia | Counselor | 525 Metro Place, Suite 100, Dublin, OH 43017 | 2017-09-05 |
| 1205365541 | Tracey Lechner | Speech-Language Pathologist | 7424 Coventry Woods Drive, Dublin, OH 43017 | 2017-06-09 |
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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 |
|---|---|---|---|---|
| 1548875719 | Janey Sampson | Case Manager/Care Coordinator | 5149 Gleason Dr # 115, Dublin, CA 94568-7627 | 2020-09-14 |
| 1558973198 | Ana M Ortiz | Case Manager/Care Coordinator | 545 Metro Pl S Ste 123, Dublin, OH 43017-5316 | 2020-08-17 |
| 1144830035 | Rosalind Fisher-mack | Case Manager/Care Coordinator | 5149 Gleason Dr Ste D115, Dublin, CA 94568-7627 | 2020-08-05 |
| 1386262269 | Megan Pedrotti | Case Manager/Care Coordinator | 5149 Gleason Dr # D115, Dublin, CA 94568-7627 | 2020-07-08 |
| 1184242224 | Lisa Marie Casey | Case Manager/Care Coordinator | 5149 Gleason Dr. Dublin, Ca 94568, Dublin, CA 94568 | 2020-07-06 |
| 1104399724 | Emma Hartley | Case Manager/Care Coordinator | 6608 Dublin Center Dr, Dublin, OH 43017-2071 | 2019-01-07 |
| 1154890192 | Samir Britel | Case Manager/Care Coordinator | 525 Metro Pl N Ste 500, Dublin, OH 43017-5342 | 2018-11-20 |
| 1598274144 | Catherine Ann Albrecht | Case Manager/Care Coordinator | 525 Metro Place N., Dublin, OH 43017 | 2017-09-27 |
| 1437601556 | Ripple Life Care Planners, LLC | Case Manager/Care Coordinator | 565 Metro Pl S Ste 300, Dublin, OH 43017-5382 | 2016-10-25 |
| 1518416817 | Deborah Harris | Case Manager/Care Coordinator | 6450 Dougherty Rd Apt 122, Dublin, CA 94568-7604 | 2016-09-27 |
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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.