NPIMap

Organization Active NPI

KKC Life Management Services

  • Case Manager/Care Coordinator
  • Lisbon, OH
National Provider Identifier
1508456302
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
KKC LIFE MANAGEMENT SERVICES
Practice address
136 S Market St
Lisbon, OH 44432-1232
Phone
(234) 736-8425
Fax
(330) 954-0880
NPI assigned
Jan 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erica Atkins Holshue, QMHS
Title
QMHS
Phone
(234) 736-8425

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP 171M00000X Primary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

136 S Market St
Lisbon, OH 44432-1232

Mailing address

136 S Market St
Lisbon, OH 44432-1232
Phone (234) 736-8425

Other identifiers 1

IdentifierTypeStateIssuer
0381705MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL kkc.lifemanagement@yahoo.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

136 S Market St
Lisbon, OH 44432
Phone (234) 736-8425

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1508456302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 S MARKET ST",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444321232",
            "telephone_number": "234-736-8425",
            "fax_number": "330-954-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S MARKET ST",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444321232",
            "telephone_number": "234-736-8425",
            "fax_number": "330-954-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KKC LIFE MANAGEMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "ATKINS HOLSHUE",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "QMHS",
        "authorized_official_telephone_number": "234-736-8425",
        "authorized_official_credential": "QMHS"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0381705",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kkc.lifemanagement@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "136 S Market St",
            "city": "Lisbon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "444321232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lisbon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.