KJCARES SUPORTIVE LIVING SERVICES (NPI# 1912562471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912562471 |
| Entity Type | Organization |
| Organization Name | KJCARES SUPORTIVE LIVING SERVICES |
| Practice Address |
20 First Street Apt 5 St. Augustine FL 32084 |
| Practice Telephone | 9042936757 |
| Mailing Telephone | 9042936757 |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-05-09 |
| Authorized Official Name | KEVIN ROBERTS (OWNER/DIRECTOR) |
| Authorized Official Telephone | 9042936757 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
20 FIRST STREET APT 5 |
| City | ST. AUGUSTINE |
| State | FL |
| Zip Code | 32084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347599 | Cody Martyn | Pharmacist | 955 Fl-16, St. Augustine, FL 32084 | 2020-08-18 |
| 1558841684 | Kevin D Roberts | Psychologist | 20 First Street Apt 5, St. Augustine, FL 32084 | 2018-08-17 |
| 1568954576 | Gwendolyn Marie Spong | Nurse Practitioner | 2703 N Ponce De Leon Blvd., Minute Clinic #3591, Area 4, Region 46, St. Augustine, FL 32084 | 2018-06-05 |
| 1770940116 | Marian L. Turner-sharpton, Lcsw | Social Worker | 17 Pacific St., Suite 2 (growth Pointe), St. Augustine, FL 32084 | 2016-01-15 |
| 1710358932 | Florida Laboratory Analysis, LLC | Clinical Medical Laboratory | 1690 Us Highway 1 S Ste D, St Augustine, FL 32084 | 2015-10-14 |
| 1780064774 | J Mae Transportation | Non-emergency Medical Transport (VAN) | 28 N Whitney St Apt 404, St Augustine, FL 32084 | 2015-06-04 |
| 1497154520 | Suzanne Smith Weed | Nurse Practitioner | 32 Mulberry Street, Saint Augustine, FL 32084 | 2014-08-14 |
| 1447684469 | Rachel Moran | Counselor | 162 Oneida Street, St. Augustine, FL 32084 | 2013-08-27 |
| 1932545993 | Matrix Medical, LLC | Durable Medical Equipment & Medical Supplies | 56 S Dixie Hwy Ste 1, St Augustine, FL 32084 | 2013-05-17 |
| 1609138262 | Kristen Danielle Derouen | Occupational Therapist | 161 Marine Street, Suite A, St. Augustine, N/A 32084 | 2012-06-11 |
| Find all providers in zip 32084 | ||||
| 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 |
|---|---|---|---|---|
| 1407286206 | Kerry-ann Yolanda Moore | Case Manager/Care Coordinator | 1955 Us 1 South, Suite 100, St. Augustine, FL 32086-5788 | 2013-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023925 | Eddy David | Case Manager/Care Coordinator | 1118 Grayson Dr, Orlando, FL 32825-6724 | 2020-11-06 |
| 1316547615 | Kyomi Santana | Case Manager/Care Coordinator | 8100 Oak Ln Ste 4048100, Miami Lakes, FL 33016-5820 | 2020-10-27 |
| 1538768072 | Emma Eloisa Cruz | Case Manager/Care Coordinator | 1105 Cobblestone Cir Apt B, Kissimmee, FL 34744-5563 | 2020-10-24 |
| 1891394409 | Ariadna Cannet | Case Manager/Care Coordinator | 27583 Sw 143rd Ct, Homestead, FL 33032-8871 | 2020-10-23 |
| 1952900839 | Yipsia Mayrelis Cordovi Cancio | Case Manager/Care Coordinator | 3837 Sw 79th Ave Apt A, Miami, FL 33155-6755 | 2020-10-21 |
| 1326646985 | Lewis Connects | Case Manager/Care Coordinator | 885 Hickory Ave, Orange City, FL 32763-6864 | 2020-10-15 |
| 1821696071 | Dianelis Ramirez | Case Manager/Care Coordinator | 6245 Dell St, Orlando, FL 32809-4311 | 2020-10-10 |
| 1548867831 | Jessica Bickman | Case Manager/Care Coordinator | 1026 Replica Ave, Sebring, FL 33872-2720 | 2020-10-08 |
| 1447857123 | Omayra Rolon-rivera | Case Manager/Care Coordinator | 1371 Tuscana Ln Apt 6102, Davenport, FL 33896-5302 | 2020-10-05 |
| 1679180392 | Astrid C Montesinos Franco | Case Manager/Care Coordinator | 7656 Nw 5th St Apt 4f, Plantation, FL 33324-1940 | 2020-09-27 |
| Find all providers with the same taxonomy | ||||
| City | ST. AUGUSTINE |
| Zip Code | 32084 |
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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.