MIRANDA TAI CAMPBELL (NPI# 1801290408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801290408 |
| Entity Type | Individual |
| Full Name | MIRANDA TAI CAMPBELL |
| Credential | BA |
| Practice Address |
11261 Ne Knott St Portland OR 97220-1704 |
| Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
| Practice Telephone | 5032538883 |
| Practice Fax Number | 5032534401 |
| Mailing Telephone | 5032380769 |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2014-10-10 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972836872 | Miranda Campbell | Social Worker | 2346 Kings Point Dr, Dunwoody, GA 30338-5925 | 2009-09-09 |
| 1417507492 | Miranda Campbell | Behavioral Analyst | 150 W University Blvd, Melbourne, FL 32901-6982 | 2019-09-12 |
| 1851830772 | Miranda Campbell | Psychologist | 2501 W 22nd St, Sioux Falls, SD 57105 | 2017-02-13 |
| 1225196694 | Miranda Campbell | Physical Therapist | 1500 Oglethorpe Ave, Bldg 500, Athens, GA 30606-2179 | 2006-12-05 |
| Street Address |
11261 NE KNOTT ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-1704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811034069 | Phyllis Michelle Braxton | Case Manager/Care Coordinator | 11261 Ne Knott St, Portland, OR 97220-1704 | 2007-01-30 |
| 1467924928 | Jacqueline Potts | Social Worker | 11261 Ne Knott St, Portland, OR 97220-1704 | 2018-12-21 |
| 1528488251 | Amy Driscoll | Adult Companion | 11261 Ne Knott St, Portland, OR 97220-1704 | 2014-04-21 |
| 1184906406 | Byron Keith Redmond | Adult Companion | 11261 Ne Knott St, Portland, OR 97220-1704 | 2011-09-13 |
| 1093008088 | Jessica Sadie Burchett | Counselor | 11261 Ne Knott St, Portland, OR 97220-1704 | 2011-05-24 |
| 1568786218 | Tracie O Randall | Case Manager/Care Coordinator | 11261 Ne Knott St, Portland, OR 97220-1704 | 2010-03-24 |
| 1952625691 | Sarah Ella Morrill | Case Manager/Care Coordinator | 11261 Ne Knott St, Portland, OR 97220-1704 | 2010-03-24 |
| 1467591768 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 11261 Ne Knott St, Portland, OR 97220-1704 | 2007-02-05 |
| 1811034580 | Darlene Stacy Prodehl | Case Manager/Care Coordinator | 11261 Ne Knott St, Portland, OR 97220-1704 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| 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 |
|---|---|---|---|---|
| 1437775558 | John Alan Varner | Case Manager/Care Coordinator | 5833 N Lombard St, Portland, OR 97203-4115 | 2020-06-24 |
| 1750906228 | Dwell Care LLC. | Case Manager/Care Coordinator | 1720 Nw Lovejoy St Ste 202, Portland, OR 97209-2341 | 2020-06-10 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102077 | Joslyn Bailey Gheen | Case Manager/Care Coordinator | 1032 Sw Main St, Portland, OR 97205-2407 | 2019-09-05 |
| 1497311773 | Ali Tareq Ashour | Case Manager/Care Coordinator | 980 Forest Ave Ste 106, Portland, ME 04103-3357 | 2019-05-13 |
| 1427540202 | Amber Tracy Ware | Case Manager/Care Coordinator | 30 Ne Martin Luther King Jr Blvd, Portland, OR 97232-2941 | 2018-06-06 |
| 1710479209 | Katherine Anne Kerr | Case Manager/Care Coordinator | 4307 Ne 102nd Ave, Portland, OR 97220-3439 | 2018-05-31 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1083137459 | David Sague | Case Manager/Care Coordinator | 7820 Ne Holman St Ste B5, Portland, OR 97218-2841 | 2017-07-18 |
| 1538601885 | Gabriela Simone Sargent | Case Manager/Care Coordinator | 4109 Se 113th Ave, Portland, OR 97266-2226 | 2016-11-16 |
| Find all providers in PORTLAND | ||||
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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.