LARA MADDOX (NPI# 1801220637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801220637 |
| Entity Type | Individual |
| Full Name | LARA MADDOX |
| Practice Address |
805 Airport Way Fairbanks AK 99701-6039 |
| Practice Telephone | 9074568901 |
| Practice Fax Number | 9074525171 |
| Mailing Telephone | 9074568901 |
| Mailing Fax Number | 9074525171 |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2013-08-28 |
| 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 |
805 AIRPORT WAY |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-6039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861522062 | Rilene Ann | Counselor | 805 Airport Way, Fairbanks, AK 99701-6039 | 2007-03-06 |
| 1093350480 | Samantha Dee Kennett | Case Manager/Care Coordinator | 805 Airport Way, Fairbanks, AK 99701-6039 | 2019-11-09 |
| 1134635543 | Fontana Dawson | Case Manager/Care Coordinator | 805 Airport Way, Fairbanks, AK 99701-6039 | 2017-12-20 |
| 1285015008 | Fairbanks Resource Agency | Case Management | 805 Airport Way, Fairbanks, AK 99701-6039 | 2015-06-17 |
| 1346628641 | Pamela Hansen | Case Manager/Care Coordinator | 805 Airport Way, Fairbanks, AK 99701-6039 | 2015-05-07 |
| 1851786842 | Stephanie J Krost | Case Manager/Care Coordinator | 805 Airport Way, Fairbanks, AK 99701-6039 | 2015-04-06 |
| 1174916381 | Magdalena Christina Eras-sawyer | Case Manager/Care Coordinator | 805 Airport Way, Fairbanks, AK 99701-6039 | 2015-03-12 |
| 1528460342 | Stephen Michael Moore | Case Manager/Care Coordinator | 805 Airport Way, Fairbanks, AK 99701 | 2014-09-24 |
| 1780007021 | Ashley Brundage | Case Manager/Care Coordinator | 805 Airport Way, Fairbanks, AK 99701-6039 | 2014-01-22 |
| 1467713313 | Keri Smith | Case Manager/Care Coordinator | 805 Airport Way, Fairbanks, AK 99701 | 2012-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| 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 |
|---|---|---|---|---|
| 1922665132 | Yelena Petkova | Case Manager/Care Coordinator | 270 Fairhill Rd, Fairbanks, AK 99712-1614 | 2019-05-22 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1528624699 | Christy Ann Herman | Case Manager/Care Coordinator | 661 Fordham Dr, Fairbanks, AK 99709-6763 | 2019-05-14 |
| 1144795055 | Debbie A Clarke | Case Manager/Care Coordinator | 1173 Sunset Dr, Fairbanks, AK 99709-4745 | 2018-10-06 |
| 1679938096 | Rachel Pleasants | Case Manager/Care Coordinator | 1422 Hampstead Ave, Fairbanks, AK 99701-2729 | 2015-12-30 |
| 1790039824 | Tracy Marie Rodden-larson | Case Manager/Care Coordinator | 60 Hall St, Fairbanks, AK 99701-4828 | 2012-10-26 |
| 1700163565 | Anita M Rodriguez | Case Manager/Care Coordinator | 3407 Airport Way, Fairbanks, AK 99709-4761 | 2011-11-08 |
| 1295045508 | Kelly Eggleston | Case Manager/Care Coordinator | 764 Adventure Road, Fairbanks, AK 99712 | 2010-10-20 |
| 1093030025 | Robin Jane Boggs | Case Manager/Care Coordinator | 3875 Geist Rd Ste E312, Fairbanks, AK 99709-3549 | 2010-04-01 |
| 1659601771 | Georgia Reynolds | Case Manager/Care Coordinator | 526 Gaffney Rd, Suite 100, Fairbanks, AK 99701-4914 | 2010-01-12 |
| Find all providers in FAIRBANKS | ||||
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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.