TRAVAUGHN WILSON (NPI# 1902452154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902452154 |
Entity Type | Individual |
Full Name | TRAVAUGHN WILSON |
Practice Address |
460 Briarwood Dr Ste 510 Jackson MS 39206-3057 |
Practice Telephone | 6019564816 |
Practice Fax Number | 6019564817 |
Mailing Telephone | 6019564816 |
Mailing Fax Number | 6019564817 |
Enumeration Date | 2019-08-14 |
Last Update Date | 2019-08-14 |
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 |
---|---|---|---|
MS | 01670076 | 05 |
Street Address |
460 BRIARWOOD DR STE 510 |
City | JACKSON |
State | MS |
Zip Code | 39206-3057 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972631380 | David Edward Marion | Counselor | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2007-02-28 |
1821603705 | Latonya Polk | Counselor | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2020-09-09 |
1669012647 | Stacy Ann Clark | Counselor | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2020-01-08 |
1831731827 | Senida Taylor | Counselor | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2019-10-11 |
1245871698 | Tracey Bernard Davidson | Case Manager/Care Coordinator | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2019-10-07 |
1558911859 | Monica Darby | Counselor | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2019-09-18 |
1831747815 | Brandi Spires | Counselor | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2019-09-03 |
1942855788 | Willie Hilliard IIi | Case Manager/Care Coordinator | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2019-08-08 |
1730734542 | Elaine Archie Maye | Case Manager/Care Coordinator | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2019-08-08 |
1386299105 | De'neshia Coleman | Case Manager/Care Coordinator | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2019-08-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
Find all providers in zip 39206 |
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 |
---|---|---|---|---|
1023644135 | Leslie Sue Krantz | Case Manager/Care Coordinator | 8431 Oakpoint Dr, Jackson, MI 49201-9229 | 2020-03-20 |
1669008405 | Alt Best Practices Bhom2, LLC | Case Manager/Care Coordinator | 81 Crooked Stick Rd, Jackson, NJ 08527-4032 | 2020-03-12 |
1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
1336601459 | Richard Daniel Bryant | Case Manager/Care Coordinator | 950 W Monroe St Ste 600a, Jackson, MI 49202-2079 | 2019-04-05 |
1013478643 | Makeshia Warden | Case Manager/Care Coordinator | 655 Pine Ln, Jackson, MS 39212-3563 | 2019-03-27 |
1053893792 | Allison Brynne Liljestrom | Case Manager/Care Coordinator | 355 Arapahoe Ln, Jackson, WY 83001-8607 | 2018-08-29 |
1033691845 | Debra Ann Hathcock | Case Manager/Care Coordinator | 724 W Snow King Ave # 7825, Jackson, WY 83001-8498 | 2018-08-29 |
1053809053 | Natasha W Tyler | Case Manager/Care Coordinator | 5615 Brentwood Dr, Jackson, MS 39211-4233 | 2018-04-25 |
1245690924 | Darlene Bell | Case Manager/Care Coordinator | 546 Clydes Way, Jackson, GA 30233-1891 | 2016-02-24 |
1598134256 | Theodore Weber Shoaf | Case Manager/Care Coordinator | 3405 S Winding Trail Dr, Jackson, WY 83001-9257 | 2015-09-23 |
Find all providers in JACKSON |
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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.