JONATHAN LEE CARROLL (NPI# 1972126704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972126704 |
| Entity Type | Individual |
| Full Name | JONATHAN LEE CARROLL |
| Practice Address |
1363 W Spruce Ave Wasilla AK 99654-5327 |
| Mailing Address |
580 W Roy Rd Apt 2 Wasilla AK 99654-3258 |
| Practice Telephone | 9073762411 |
| Practice Fax Number | 9073523373 |
| Mailing Telephone | 9077755684 |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-05-27 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326421785 | Jonathan Carroll | Pharmacist | 755 Nw Gilman Blvd, Issaquah, WA 98027-5357 | 2015-07-02 |
| 1831586064 | Jonathan R. Carroll | Psychologist | 100 Century Dr, Worcester, MA 01606 | 2015-04-26 |
| 1093115818 | Jonathan Carroll | Physician Assistant | 1600 Sw Archer Rd, Division of Vascular Surgery - Box 100128, Gainesville, FL 32610-0128 | 2014-08-28 |
| 1356658637 | Jonathan Carroll | Physical Therapist | 800 Falmouth Rd, 103c Summerfiled Park, Mashpee, MA 02649-3303 | 2010-09-08 |
| 1548471956 | Jonathan David Carroll | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2007-05-25 |
| Street Address |
1363 W SPRUCE AVE |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-5327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326010232 | Kathleen Elizabeth Young | Family Medicine | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2006-02-03 |
| 1396354544 | Ann Victoria Andrus | Peer Specialist | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2020-07-23 |
| 1508481599 | Laura Yvonne Rhowmine | Case Manager/Care Coordinator | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2020-06-15 |
| 1902421118 | Kirsten Marie Knight | Case Manager/Care Coordinator | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2020-06-12 |
| 1922623396 | Anita Irene Powell | Peer Specialist | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2020-06-11 |
| 1467076471 | Lavina J Becerra | Peer Specialist | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2020-06-05 |
| 1730703638 | Caitlin Anne Jones | Case Manager/Care Coordinator | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2020-06-05 |
| 1891319851 | Sydney Tenboer | Peer Specialist | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2020-06-04 |
| 1255955266 | Selenaann Milicant Kristine Griswold | Counselor | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2020-06-04 |
| 1124642376 | Denise Gail Rauch | Case Manager/Care Coordinator | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2020-06-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
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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 |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1922625276 | Heather Tenboer | Case Manager/Care Coordinator | 3480 W Birch Meadows Rd, Wasilla, AK 99654-0534 | 2020-07-02 |
| 1245850403 | Positive Path LLC | Case Manager/Care Coordinator | 7647 W Tia Terrace Dr, Wasilla, AK 99623-0332 | 2020-04-17 |
| 1093361065 | Chad A Stone | Case Manager/Care Coordinator | 2619 N Chiquita Cielo Dr, Wasilla, AK 99654-3579 | 2019-08-14 |
| 1063071660 | Links Mat-su Parent Resource Center | Case Manager/Care Coordinator | 777 N Crusey St Ste A101, Wasilla, AK 99654-7100 | 2019-06-07 |
| 1801450382 | Desiree Feringa | Case Manager/Care Coordinator | 6640 S Calista Drive, Wasilla, AK 99623 | 2019-04-30 |
| 1649737206 | Donald Cox | Case Manager/Care Coordinator | 777 N Crusey St Ste B101, Wasilla, AK 99654-7101 | 2019-03-01 |
| 1427545615 | Rebecca Racenet | Case Manager/Care Coordinator | 4801 S Timberline Cir, Wasilla, AK 99654-8750 | 2018-04-13 |
| 1952806283 | Shelia M Hansen | Case Manager/Care Coordinator | 500 E Swanson Ave Ste 5, Wasilla, AK 99654-7197 | 2018-03-28 |
| 1396255592 | Juanita C White | Case Manager/Care Coordinator | 4001 E Ruth Dr Unit C, Wasilla, AK 99654-7546 | 2017-10-03 |
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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.