Erica Jefferson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

17850 Baker Ave
Country Club Hills, IL 60478-4729

Phone

(708) 922-0538

NPI assigned

Apr 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grand Prairie Services

  • Federally Qualified Health Center (FQHC)
  • Chicago Heights, IL
  • NPI 1447723564
  NPD (past)
• Grand Prairie Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Country Club Hills, IL
  • NPI 1730363458
  NPD (past)

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1831728245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 DARTMOUTH AVE",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604431515",
            "telephone_number": "708-639-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17850 BAKER AVE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604784729",
            "telephone_number": "708-922-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holy Medicare Inc
• Homecoming Healthcare Inc.
• Janel Horn
• Innovative Health Care Service of Midwest
• Isd Renal Inc (Country Hills Dialysis)
• Lunya Jenkins
• Elona Johnson
• Geralyn L Johnson
• Gwendolyn L Johnson
• Leonna Johnson

• Case Manager/Care Coordinator in Country Club Hills, IL
• Providers in Country Club Hills, IL by specialty
• Case Manager/Care Coordinator in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.