Nebraska Medicaid Excluded Providers (007) - Nebraska Department of ...

[Pages:22]This list is not to be considered comprehensive of all providers excluded from participation in the Nebraska Medicaid program; action by other federal or state entities may also result in exclusion. The providers identified herein are those that have been excluded by the Nebraska Department of Health and Human Services, Division of Medicaid & Long-Term Care. This list may or may not include providers excluded as a result of action taken by other federal or state entities. Such actions may be taken by, for example purposes only, the Nebraska Department of Health and Human Services, Division of Public Health, Health Licensure & Investigations Section, HHS-OIG LEIE, GSA/EPLS/SAM, and/or Medicare. Searching this list should be done in conjunction with searches of all appropriate databases.

In accordance with 471 NAC 2-005.02(A)(iii) Excluded Person or Entity: No clinic, group, corporation, or other association which is a provider of services shall submit claims for payment to the Department for any services or supplies provided by a person within the organization which has been excluded from participation in NMAP except for those services or supplies provided before the termination. If these provisions are violated by a clinic, group, corporation, or other association, the Department may terminate the organization and/or any individual person within the organization responsible for the violation. A provider shall not submit any claims to NMAP that contain the costs of services provided by excluded persons or entities.

In order to be considered for removal from the NMEP list and/or reactivation as a Nebraska Medicaid-enrolled provider, please complete and submit the Nebraska Medicaid NMEP Removal/Reactivation Questionnaire found at the link below.



Updated: 12/21/2023

To verify potential matches with providers listed below please send a request to DHHS.MedicaidProgramIntegrity@.

Date Added to

NMEP

Provider Name

11/25/2020 A Home for Me

10/31/2016 Absolute Homecare, Inc.

5/27/2021 Acadian Diagnostic Laboratories, LLC

10/29/2019 Ace of Blades

12/29/2017 Adam, Arbab

Adams Allen, Teresa M.

10/3/2018 Aden, Shirley

12/21/2023 Advantage Treatment Center, Inc.

10/3/2018 Aguilar, Jon D

12/16/2016 Akara, Clements

6/19/2019 Akpokli, Ursula

2/23/2015 Al Alwani, Monther

Al Boujawari, Mohammad

6/6/2022 Al-Badry, Ali

6/6/2018 Al-Mansuri, Ammar

2/12/2019 Alama, Suhad

1/2/2019 Alarcon, Ariana

5/21/2018 Albertus, Carol

12/29/2017 Alfatlawi, Adnan A.

6/15/2018 Alhelli, Husham

6/6/2022 Ali, Maman

5/4/2018 Alkire, Peggy

1/21/2021 All American Medical Supplies, LLC

2/23/2018 9/14/2018

Allen-Jensen, Kelli J.

Alliance on Supports and Developmental Disabilites LLC Allison, Kathleen Marie

11/6/2020 Almawaldi, Mohamad

2/26/2020 Alpha Care Services

10/30/2015 Alston, Jeannine

10/11/2017 Alvarado, Idalia

6/15/2018 Alvarado, Janette

10/4/2017 Alvarado, Jose

3/17/2021 Alvernia's Handi Hands, LLC

6/18/2018 Ambrose, Odessa

1/11/2018 Andersen, Amy

10/11/2017 Anderson, Ashley

NPI

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1316370950

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI not issued

1114557915

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1710181151

Atypical Provider Type-NPI Not Issued

1972744431

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1750390027

Provider Type DD Provider

Sanction Type Termination

Effective Date

3/3/2020

Term Permanent

Personal Assistance Service

Termination 2/9/2016 Permanent

Laboratory

Termination 11/21/2020 Permanent

Chore

Termination 7/21/2019 Permanent

Personal Assistance Service

Termination 10/7/2017 Permanent

Personal Assistance Service

Termination 8/19/2007 Permanent

Chore

Termination 7/30/2018 Permanent

Residential Rehabilitation (REST) Termination 8/8/2023 Permanent

Chore

Termination 7/23/2018 Permanent

Retailer

Exclusion

2/1/2016 Permanent

Chore

Termination 6/12/2019 Permanent

Personal Assistance Service

Termination 9/19/2014 Permanent

Personal Assistance Service

Termination 3/26/2010 Permanent

DD Provider

Exclusion

5/9/2022 Permanent

Chore

Termination 1/16/2018 Permanent

Personal Assistance Service

Termination 1/3/2019 Permanent

Community Living Day Support

Termination 9/4/2018 Permanent

Personal Assistance Service

Termination 1/16/2018 Permanent

Personal Assistance Service

Termination 10/7/2017 Permanent

Personal Assistance Service

Termination 2/4/2018 Permanent

Physician

Termination 6/6/2022 Permanent

Chore

Termination 11/11/2017 Permanent

Retailer

Termination 10/15/2020 Permanent

Chore

Termination 11/25/2017 Permanent

DD Provider

Termination 8/24/2018 Permanent

Chore

Termination 5/23/2011 Permanent

Physician

Termination 11/6/2020 Permanent

1659839207

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Home Health Agency Chore Chore Chore

Personal Assistance Service PAS/CHORE Chore Chore Chore

Termination 2/14/2020 Permanent Termination 8/14/2015 Permanent Termination 8/9/2017 Permanent Termination 2/19/2018 Permanent Termination 6/4/2017 Permanent Termination 3/3/2021 Permanent Termination 2/25/2018 Permanent Termination 10/14/2017 Permanent Termination 8/19/2017 Permanent

End Date NA NA NA NA NA N/A NA NA NA N/A NA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

Reason for Action

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Updated: 12/21/2023

Date Added to

NMEP

Provider Name

1/10/2019 Anderson, Stacey

12/26/2017 Andre, Kent

5/15/2018 Andrews, Crystal A

9/20/2019 Anit, Leandro

11/29/2016 Argo, Julie L.

10/13/2020 Arnold, Andrea

1/21/2021 Armstrong, Robin

3/25/2021 Arriaga, Dolores

9/27/2017 Ascencio, Julie

7/3/2018 Atwood, Mary

3/21/2019 Augustin, Joshua

2/12/2019 Austin, Elizabeth

Aviles, Andrew A.

3/14/2022 Axland, Taylor

5/26/2017 Ayal, Ragad

6/23/2023 Baguian, Abdramane

5/15/2018 Baker, Alice M.

5/27/2016 Baker, Amber

5/27/2016 Baker, Rebecca Christine

Baldwin, Patrice

10/11/2017 Ball, Shaquea

3/6/2018 Barnes, Demetria

9/27/2017 Barnum, Catessa

3/26/2018 Barta, Christina

6/15/2018 Bartak, Thomas

Bartusek, Jonathan

10/4/2017 Bassett, Tory

10/3/2018 Bates, Brittany

10/11/2017 Beck, Theodore

8/12/2019 Becker, Michelle

Becker, Stephanie PLMHP

5/30/2018 Beckman, Joee J

5/30/2018 Beel, Misty D

7/1/2022 Bell, Wyatt

2/11/2022 Belle Terrace

5/4/2018 Benford, Ralph

7/3/2018 Benjamin, Rose Marie

11/30/2016 Benson, Lana

8/24/2016 Bentley, Rebekah S.

5/21/2018 Benzel, Angela

9/27/2017 Bernhardt, Tanya

6/23/2023 Berry, Cora Simmerman

12/5/2017 Better Lives, LLC

3/21/2019 Birchwood Manor

3/29/2019 Bishop, Brittany

10/11/2017 Biswakarma, Rudra

3/29/2019 Black, Gwen

3/24/2023 Bland, Rayneale

2/24/2023 Blasiny, Mumtaz

12/26/2017 Blissful Caring Hearts

1/10/2022 Boham, Morgan

NPI

Atypical Provider Type-NPI Not Issued

Provider Type Chore

Sanction Type Termination

Effective Date

1/6/2018

Term Permanent

1245425974

Physician

Termination 12/14/2017 Permanent

Atypical Provider Type-NPI Not Issued

Personal Assistance Service

Termination 1/13/2018 Permanent

1215141700

Physician

Termination 8/11/2017 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1447389200

Chore Personal Assistance Service

Chore PAS/CHORE

Chore Licensed Independent Mental Health

Practitioner

Exclusion Termination

Exclusion Termination Termination Termination

9/16/2016 Permanent 2/5/2015 Permanent 1/14/2021 Permanent 3/16/2021 Permanent 5/30/2017 Permanent 9/23/2017 Permanent

1033623632

Mental Health Professional

Termination 3/19/2019 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI not issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Terminated Prior to NPI Requirement

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Personal Assistance Service Personal Assistance Service

Chore Personal Assistance Service

DD Provider Personal Assistance Service Personal Assistance Service Personal Assistance Service Personal Assistance Service Personal Assistance Service Personal Assistance Service Personal Assistance Service

Chore Personal Assistance Service

DD Provider Chore Chore Chore

PAS/CHORE Provisionally Licensed Mental Health

Practitioner PAS/CHORE

Chore DD Provider

Termination Termination Termination Termination

Exclusion Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination

Exclusion

9/10/2018 Permanent 6/6/2013 Permanent 3/9/2022 Permanent 3/10/2017 Permanent 6/9/2023 Permanent 1/13/2018 Permanent 1/27/2016 Permanent 2/29/2016 Permanent 5/31/2013 Permanent 8/19/2017 Permanent 11/25/2017 Permanent 9/25/2017 Permanent 9/29/2017 Permanent 2/4/2018 Permanent 5/31/2013 Permanent 6/4/2017 Permanent 8/13/2018 Permanent 9/16/2017 Permanent 8/1/2019 Permanent 1/13/2010 Permanent 2/11/2018 Permanent 2/11/2018 Permanent 6/29/2022 Permanent

1508342270

Nursing Home

Termination 2/9/2021 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Personal Assistance Service Personal Assistance Service

Chore Disability CC

Chore Personal Assistance Service

Termination 11/11/2017 Permanent

Termination 4/2/2018 Permanent

Exclusion

9/19/2016 Permanent

Termination 7/15/2016 Permanent

Termination 2/4/2018 Permanent

Termination 5/30/2017 Permanent

1740655265

Mental Health Professional

Termination 5/8/2023 Permanent

1003117508

Retailer

Termination 10/29/2017 Permanent

1558368050

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Nursing Home Personal Assistance Service

Chore PAS/CHORE DD Provider Personal Assistance Service Personal Assistance Service DD Provider

Termination 3/21/2019 Permanent Termination 9/24/2018 Permanent Termination 9/2/2017 Permanent Termination 9/24/2018 Permanent Termination 10/19/2022 Permanent Termination 1/26/2023 Permanent Termination 12/14/2017 Permanent Termination 12/29/2021 Permanent

End Date N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A NA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

Reason for Action

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Updated: 12/21/2023

Date Added to

NMEP

Provider Name

2/26/2020 Bokelman, Ronda

10/11/2017 Bolden Grant, Lynette

5/27/2016 Bolles, Tammy

9/28/2017 Bond, Daphne

1/2/2018 Borah, Candace Anne

8/24/2016 Borgaila, Jordan

2/24/2023 Borges, Zachary

9/27/2017 Borrego-Baker, Rebecca

9/27/2017 Botts, Denise

5/7/2021 Bower, Cynthia A

2/23/2018 Bowling-Martin, Kimberly

12/1/2014 Bowman, Jessica R.

12/27/2017 Braddy, Tyra

10/11/2017 Brass, Edith

1/10/2018 Brazda, Kimberly

6/25/2018 Brazile, Latasha

2/26/2020 Brenda's TLC

12/29/2017 Brethouwer, Jeffrey

10/3/2018 Bristol, Mary

12/8/2017 Brooks, Lisa

5/26/2017 Brown, Craig

4/23/2018 Brown, Shelly L

6/25/2018 Brown, Shkaria D

11/21/2023 Brown, Special J.

5/21/2018 Bruntz, Diane

12/26/2017 Brunzo, Jamie L.

Bryant, Kenya Sade

4/13/2018 Brye, Sabrina

9/28/2017 Burcham, Sharon

9/20/2022 Burden, Shyann

6/13/2017 Burgess, Julie

10/4/2017 Burnett, Angela

9/27/2017 Burr, Candace

11/5/2018 Burton, Reginald

11/5/2021 Bushman, Annette

5/26/2017 Cabral, Angel D.

5/26/2017 Cabral James

9/27/2017 Caha, Sidonia

9/22/2016 Callejas, Stephanie

5/15/2018 Calloway, Belinda J

9/4/2019 Calloway, Isaiah

Camacho, Victor Alfonso

6/19/2015 Cambron (Fendrick), Rebecca

9/27/2017 Campbell, Dorine

5/4/2018 Campbell White, Marvell

10/3/2018 Campos, Ricardo

10/31/2014 Cannon, Shuronda

9/27/2017 Canseco, Kelly

2/24/2014 Cantu, Deserri

10/3/2018 Capazo, Catherine

10/3/2018 Cappellano, Emma

NPI

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI not issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI not issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI not issued

Atypical Provider Type-NPI Not Issued

1740290253

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1043518673

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1134161508

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI not issued

Atypical Provider Type-NPI not issued

Provider Type Chore

Personal Assistance Service Personal Assistance Service

PAS/CHORE PAS/CHORE DD Provider Companion and Personal Care Personal Assistance Service PAS/CHORE

Chore Personal Assistance Service

Chore PAS/CHORE Personal Assistance Service Personal Assistance Service PAS/CHORE

Chore Personal Assistance Service

Chore Chore Physician Personal Assistance Service Personal Assistance Service Personal Assistance Service Chore Personal Assistance Service Psychologist Personal Assistance Service Personal Assistance Service Companion and Personal Care Personal Assistance Service Personal Assistance Service Chore Physician Chore Chore Chore Personal Assistance Service Personal Assistance Service Personal Assistance Service Personal Assistance Service Chore Personal Assistance Service Personal Assistance Service Personal Assistance Service Chore Personal Assistance Service Personal Assistance Service Personal Assistance Service Chore Personal Assistance Service

Effective

Sanction Type

Date

Term

Termination 11/25/2019 Permanent

Termination 8/19/2017 Permanent

Termination 1/11/2016 Permanent

Termination 8/10/2017 Permanent

Termination 5/14/2017 Permanent

Exclusion

6/27/2016 Permanent

Termination 2/8/2023 Permanent

Termination 5/30/2017 Permanent

Termination 5/30/2017 Permanent

Termination 3/18/2021 Permanent

Termination 11/25/2017 Permanent

Termination 9/30/2014 Permanent

Exclusion

8/28/2017 Permanent

Termination 9/16/2017 Permanent

Termination 5/14/2017 Permanent

Termination 3/15/2018 Permanent

Termination 02/14/20 Permanent

Termination 10/7/2017 Permanent

Termination 8/13/2018 Permanent

Termination 11/14/2017 Permanent

Termination 2/22/2017 Permanent

Termination 12/9/2017 Permanent

Termination 4/2/2018 Permanent

Termination 10/10/2023 Permanent

Termination 1/16/2018 Permanent

Termination 12/19/2017 Permanent

Termination 8/30/2013 Permanent

Termination 12/2/2017 Permanent

Termination 8/28/2017 Permanent

Termination 9/17/2022 Permanent

Termination 5/3/2017 Permanent

Termination 6/4/2017 Permanent

Termination 8/14/2017 Permanent

Termination 8/15/2017 Permanent

Termination 9/4/2021 Permanent

Termination 3/24/2017 Permanent

Termination 3/30/2017 Permanent

Termination 5/30/2017 Permanent

Termination 3/26/2013 Permanent

Termination 1/13/2018 Permanent

Termination 8/26/2019 Permanent

Termination 6/3/2011 Permanent

Termination 11/21/2014 Permanent

Termination 5/30/2017 Permanent

Termination 11/11/2017 Permanent

Termination 8/24/2018 Permanent

Termination 7/25/2014 Permanent

Termination 5/30/2017 Permanent

Termination 7/25/2013 Permanent

Termination 8/27/2018 Permanent

Termination 7/30/2018 Permanent

End Date N/A N/A N/A N/A N/A N/A N/A N/A N/A NA N/A N/A N/A N/A N/A N/A NA N/A NA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A NA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A NA N/A N/A N/A NA NA

Reason for Action

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Updated: 12/21/2023

Date Added to

NMEP

Provider Name

9/30/2016 Carde-Bernal, Jose

6/25/2018 Cardenas Gomez, Lucia

3/17/2021 Care at Heart Senior Care, LLC

5/15/2018 Carl, Emily

2/21/2017 Carlson, Janelle L.

9/27/2017 Carrizales, Linda

2/21/2017 Carter, Joel

10/11/2017 Carter, Mariah

1/2/2018 Casey, Beryl

8/18/2015 Casey, Robin R.

6/15/2018 Casillas, Shalee

6/15/2018 Castro, Sheila

8/24/2016 Castellaw, Christina

10/31/2016 Cavalic, Adisa

6/18/2018 Cemper, Ivy

11/29/2016 Chamberlin, Barbara

10/25/2022 Champions of Services and Health, Inc.

1/11/2018 Chapman, Bobbie

3/30/2016 Chatmon, Laron

5/3/2018 Chavez, Rosalinda

10/4/2017 Chavez, Victoria

6/15/2018 Cheever, Melissa

2/22/2019 Cherry, Bryce

12/21/2023 Chillous, Lorenzo

3/23/2018 Chleborad, Paul

Choice Medical Transportation

11/5/2021 Choices Counseling & Consulting Inc

12/30/2016 Church, Kimberly

3/13/2019 Clark, Charlean

4/2/2015 Clark, Danielle J.

5/4/2018 Clark, David

2/24/2014 Clark, Foch

6/25/2018 Clark, Latoya

Clark, Megan M.

6/6/2022 Claro Scientific Laboratories

9/27/2017 Clay, Candice

9/14/2017 Clayborn, Holli

5/26/2017 Cleveland, Deann Accoya

5/18/2018 Clinchard, Daniel

2/21/2017 Clinton, Diann

8/15/2014 Cobbs, Tiffany

5/30/2018 Cole, Mareena

4/13/2018 Coles, Vivian

2/26/2020 Collazo, Gilberto

12/21/2023 Collier, Shiniqua

5/27/2016 Colliers, Jordan Dayne

5/10/2019 Collins, Miranda

4/13/2018 Colson, Christina

9/27/2017 Colwell, Alanna

7/10/2018 Compassionate Souls, LLC

1/11/2018 Compton, Crystal

NPI

Provider Type

Sanction Type

1770993784

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Provisionally Licensed Drug & Alcohol Counselor Chore

PAS/CHORE Chore

Community Living Day Support Personal Assistance Service

Termination Termination Termination Termination Termination Termination

Effective Date

8/19/2016 3/22/2018 2/22/2021 1/13/2018 1/6/2017 5/30/2017

Term Permanent Permanent Permanent Permanent Permanent Permanent

1598825796

Physician

Termination 12/5/2016 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Chore Chore Personal Assistance Service Chore Personal Assistance Service Chore Personal Assistance Service Chore Personal Assistance Service DD Provider Personal Assistance Service Personal Assistance Service Chore Chore Chore Respite Personal Assistance Service

Termination 5/14/2017 Permanent

Termination 5/14/2017 Permanent

Termination 5/6/2015 Permanent

Termination 2/19/2018 Permanent

Termination 2/19/2018 Permanent

Exclusion

6/27/2016 Permanent

Termination 8/1/2016 Permanent

Termination 3/1/2018 Permanent

Termination 10/13/2016 Permanent

Termination 9/17/2022 Permanent

Termination 10/21/2017 Permanent

Termination 2/9/2016 Permanent

Termination 11/25/2017 Permanent

Termination 6/4/2017 Permanent

Termination 2/4/2018 Permanent

Termination 2/21/2019 Permanent

Termination 8/22/2023 Permanent

1275793473

Professional Clinic

Termination 2/27/2018 Permanent

Atypical Provider Type-NPI Not Issued

Transportation

Termination 12/3/2009 Permanent

1689757957

Professional Clinic

Termination 10/23/2021 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Chore Personal Assistance Service

Chore/Transportation Personal Assistance Service Personal Assistance Service Personal Assistance Service

Chore

Exclusion 11/10/2016 Permanent Termination 2/26/2019 Permanent Termination 1/6/2015 Permanent Termination 11/11/2017 Permanent Termination 1/16/2013 Permanent Termination 3/15/2018 Permanent Termination 3/29/2011 Permanent

1609388842

Laboratory

Termination 5/18/2022 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1629147160

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Chore Chore Personal Assistance Service PAS/CHORE Licensed Independent Mental Health Practitioner Personal Assistance Service PAS/CHORE Personal Assistance Service

Termination Exclusion Exclusion

Termination Termination Termination Termination Termination

5/30/2017 Permanent 6/24/2017 Permanent 3/7/2017 Permanent 4/13/2018 Permanent 11/15/2016 Permanent 6/9/2014 Permanent 2/11/2018 Permanent 12/2/2017 Permanent

1689767550

Physician

Termination 2/12/2020 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Companion and Personal Care Personal Assistance Service Personal Assistance Service Chore Chore

Community Living Day Support Personal Assistance Service

Termination 8/22/2023 Permanent Termination 3/3/2016 Permanent Termination 5/9/2019 Permanent Termination 12/9/2017 Permanent Termination 5/30/2017 Permanent Termination 6/28/2018 Permanent Termination 10/21/2017 Permanent

End Date N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A NA NA NA NA NA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

Reason for Action

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Updated: 12/21/2023

Date Added to

NMEP

Provider Name

6/19/2019 Cook, La Mesha

9/22/2016 Cook, Lawanda (aka's Gould & Sherman)

12/12/2019 Cooper, Lori

1/10/2018 Cooper, Judith

9/27/2017 Correa, Marsha

6/14/2017 Corter, Amy

6/15/2018 Counts, Lorraine

9/27/2017 Cowell, Catherine

4/13/2018 Cowins, Lance

6/23/2017 Cozart, Sandra

4/22/2022 Cozine, Debra

6/6/2022 Craw, Amanda

4/2/2015 Crawford, Lynn M.

10/3/2018 Crawford Jr.,Gerry D.

Crawley, Annette K.

6/23/2017 Crespo-Alvarez, Walkira

6/25/2018 Cress, San Juanita

10/11/2017 Crewdson, Teresa

12/27/2017 Cross, Phyllisa

6/18/2018 Cruz, Yamilka Del Pino

Cudmore, Alexis May

5/21/2018 Cumbie, Christopher

Curry, Raenae L

Cusatis, Melissa R.

6/15/2018 Curtis, June

11/25/2020 D & S Center for Intelectual and Development

10/3/2018 Dailey, Felicia D

9/27/2017 Dale, Kelly Rhoades

Dalton, Michelle

9/27/2017 Damayanti, Mariana

6/22/2017 Damme, Jeffery Alan

2/17/2017 Dancer, Denise

3/20/2023 Darwin Jr., Brian

2/24/2023 Darwin Sr., Brian

5/3/2018 Davis, Alexander

1/11/2018 Davis, Chad

5/3/2018 Davis, Dana

8/26/2016 Davis, Jennifer K.

10/4/2017 Davis, Latawndra

6/15/2018 Dean, Donald

Dehart, Marilyn

5/15/2018 Dejaynes, Darlyn A

6/15/2018 De La Rosa, Aaron

12/14/2022 De Los Angeles, Reynaldo

7/10/2018 Delgado, Wilfredo

9/27/2017 Demuth, Mary

5/4/2018 DeMuth, Tricia

Deneui Caloca, Angela

5/4/2018 Detweiler, Mary

12/29/2017 Deuerlein, Amanda

9/27/2017 Devers, Carolyn

NPI

Atypical Provider Type-NPI Not Issued

1720271182

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1679937486

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

NA

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1508957366

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1578572210

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1104038090

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Provider Type Chore

Sanction Type Termination

Effective Date

6/12/2019

Term Permanent

Licensed Mental Health Practitioner Termination 6/27/2016 Permanent

Personal Assistance Service

Termination 11/18/2019 Permanent

Personal Assistance Service

Termination 5/14/2017 Permanent

Personal Assistance Service

Termination 5/30/2017 Permanent

Chore

Termination 4/14/2017 Permanent

Chore

Termination 2/4/2018 Permanent

Chore

Termination 5/30/2017 Permanent

Chore

Termination 12/2/2017 Permanent

Personal Assistance Service

Termination 4/3/2017 Permanent

PAS/CHORE

Provisional Mental Health Professional

Chore

Termination 4/9/2022 Permanent Termination 5/9/2022 Permanent Termination 12/19/2014 Permanent

Personal Assistance Service

Termination 7/23/2018 Permanent

Psychologist

Termination 8/30/2013 Permanent

Personal Assistance Service

Exclusion

3/27/2017 Permanent

PAS/CHORE

Termination 3/15/2018 Permanent

Personal Assistance Service

Termination 5/14/2017 Permanent

Personal Assistance Service

Termination 12/19/2017 Permanent

Chore

Termination 2/25/2018 Permanent

DD Provider

Termination 10/3/2011 Permanent

Chore

Termination 1/16/2018 Permanent

Chore

Termination 10/28/2011 Permanent

Chore

Termination 3/17/2011 Permanent

Chore

Termination 2/4/2018 Permanent

DD Provider

Termination 3/3/2020 Permanent

PAS/Chore

Termination 8/20/2018 Permanent

Personal Assistance Service

Termination 5/30/2017 Permanent

Personal Assistance Service

Termination 5/31/2013 Permanent

Chore

Termination 5/30/2017 Permanent

Physician

Termination 4/13/2017 Permanent

Personal Assistance Service

Termination 4/28/2016 Permanent

Personal Assistance Service

Exclusion

3/8/2023 Permanent

Companion and Personal Care

Exclusion

2/8/2023 Permanent

Chore

Termination 11/11/2017 Permanent

Chore

Termination 9/2/2017 Permanent

Chore

Termination 11/11/2017 Permanent

Chore

Termination 7/14/2016 Permanent

Personal Assistance Service

Termination 6/4/2017 Permanent

Chore

Termination 2/19/2018 Permanent

Chore

Termination 2/1/2012 Permanent

Chore

Termination 1/13/2018 Permanent

Personal Assistance Service

Termination 2/19/2018 Permanent

Physician

Termination 9/17/2022 Permanent

Personal Assistance Service

Termination 6/12/2018 Permanent

Chore

Termination 5/30/2017 Permanent

Chore

Licensed Independent Mental Health Practitioner

Personal Assistance Service

Termination Termination Termination

11/25/2017 Permanent 8/28/2013 Permanent 11/11/2017 Permanent

Chore

Termination 10/7/2017 Permanent

Personal Assistance Service

Termination 5/30/2017 Permanent

End Date N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A NA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

Reason for Action

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Updated: 12/21/2023

Date Added to

NMEP

Provider Name

12/8/2017 DeWispelare, Logan

6/18/2018 Dimmitt, Debra

9/27/2017 Dischinger, Charles

4/2/2015 Dixon, Sara R.

6/15/2018 5/13/2018

Dodd, Robin

Dodson Martin, Jane LMHP (Central Counseling) Dohmen, Rose Ann

10/11/2017 Donaldson, Diane M

1/11/2018 Donat, Bill

2/21/2017 Dorsch, Michael Allen

11/6/2017 Doumassy, Shavonne

9/27/2017 Drinkwalter, Cindy

3/30/2016 Drummond, Eugene

6/15/2018 Dubray, Victoria

6/15/2018 Dudas, Judith

11/3/2020 Dufek, Rhona

1/2/2018 Duhachek, Barbara

10/11/2017 Duer, Aubrey

5/4/2018 Duffy, Sharon L.

6/22/2016 Dukes, Debra Jane

Dumarce, Donathan

1/4/2018 Dumas, Alesha

Duncan, Mary Jennifer

11/29/2016 Dunn, Tierra

4/13/2018 Dunn, Tiffany

12/13/2023 Durham, Joseph

4/15/2014 Duty, Debra Jolene

Duwe, David

6/15/2018 Eblin, Jessica

8/4/2020 Eck, Katie

8/8/2016 Edington, Tina M.

12/29/2017 Einspahr, Helen

5/31/2018 Einspahr, Kent

7/20/2018 Elliott, Michelle

3/29/2019 Ellis, Sheila

10/3/2018 Engert , Laurie S

Ensrud, Sherri

10/3/2018 Evans, Daniel

1/5/2018 Everly, JoAnn L.

9/28/2017 EVOL Consulting, LLC

1/10/2022 Family Dental Associates

9/14/2017 Fast Forward Community Care Services

1/19/2023 Fee, Virginia

12/20/2021 Feigenbaum, Amy

Feik, Debra K.

1/24/2019 Fidelity Home Health Care, LLC

10/4/2017 Fierro, Araceli

10/4/2017 Filanowski, Peter Paul

6/15/2018 Finnegan, Jeff

Firley-Clark, Ashley

10/31/2014 Fisher, Amy Nichol

NPI

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Terminated Prior to NPI Requirement

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1457344954

Provider Type Chore

Effective

Sanction Type

Date

Term

Termination 10/31/2017 Permanent

Chore

Termination 3/1/2018 Permanent

Chore

Termination 5/30/2017 Permanent

Personal Assistance Service

Termination 10/21/2010 Permanent

Personal Assistance Service

Termination 2/19/2018 Permanent

Licensed Mental Health Practitioner Termination 4/25/2008 Permanent

Respite

Termination 12/9/2017 Permanent

Chore

Termination 09/16/2017 Permanent

Retailer

Termination 8/9/2017 Permanent

1902186539

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1730419656

Physician Assistant PAS/CHORE

Personal Assistance Service Chore

PAS/CHORE Chore

PAS/CHORE PAS/CHORE

Chore Respite Chore Personal Assistance Service Personal Assistance Service Chore Homemaker In Home Chore Personal Assistance Service Chore Personal Assistance Service Chore Personal Assistance Service Chore Chore Chore PAS/CHORE Chore Personal Assistance Service Personal Assistance Service Chore PAS/CHORE Professional Clinic

Termination 12/5/2016 Permanent

Termination 8/20/2017 Permanent

Termination 5/30/2017 Permanent

Termination 2/12/2016 Permanent

Termination 2/19/2018 Permanent

Termination 2/4/2018 Permanent

Termination 7/20/2020 Permanent

Termination 5/14/2017 Permanent

Termination 9/16/2017 Permanent

Termination 11/11/2017 Permanent

Termination 5/3/2016 Permanent

Termination 7/29/2013 Permanent

Termination 12/28/2017 Permanent

Termination 6/11/2011 Permanent

Termination 10/7/2016 Permanent

Termination 12/2/2017 Permanent

Termination 7/6/2023 Permanent

Termination 11/8/2013 Permanent

Termination 4/4/2013 Permanent

Termination 2/4/2018 Permanent

Termination 7/31/2020 Permanent

Termination 6/13/2016 Permanent

Termination 10/7/2017 Permanent

Termination 1/21/2018 Permanent

Exclusion

5/24/2018 Permanent

Termination 9/24/2018 Permanent

Termination 7/23/2018 Permanent

Termination 2/8/2013 Permanent

Termination 6/30/2018 Permanent

Termination 5/14/2017 Permanent

Termination 9/5/2017 Permanent

1528238995

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1841546926

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Dentist Chore Chore DD Provider Personal Assistance Service Home Health Agency Chore Chore Personal Assistance Service Personal Assistance Service Chore

Termination 12/17/2021 Permanent

Termination 6/24/2017 Permanent

Exclusion

1/14/2023 Permanent

Termination 12/17/2021 Permanent

Termination 6/6/2007 Permanent

Termination 1/11/2019 Permanent

Termination 6/4/2017 Permanent

Termination 6/4/2017 Permanent

Termination 2/4/2018 Permanent

Termination 1/27/2010 Permanent

Termination 5/9/2014 Permanent

End Date N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A NA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

Reason for Action

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Updated: 12/21/2023

Date Added to

NMEP

Provider Name

5/30/2018 Fisher, Shanna

6/25/2018 Fleek, Janet

9/1/2021 Fleming, Richard M.

Flemons, Lawrence R

2/26/2020 Flores, Brenda

9/27/2017 Follett, Shannon

12/21/2023 Ford, Sarah

6/25/2018 Ford, Tanina

6/15/2018 Fossler, Bruce

5/21/2018 Foster, Eartha

5/13/2019 Foster, Johnna

5/3/2021 Fox, Ashley (aka Mason)

6/15/2018 Fraedrich, Brandy

6/15/2018 Frank, Katelin

12/21/2018 Franklin, Diamonique

11/3/2020 Franklin, Kevin

4/11/2019 Franklin, Michael

9/14/2018 Fraser, Jeffrey

5/3/2018 Frieze, Braydon L.

Fuestman, Paula

9/30/2016 Fuller, Rosey L.

5/26/2017 Fullerton, Elena Mercedes

6/15/2018 Fulsass, Ashley

10/11/2017 Furman, Mariann

8/14/2020 Gaffney, Marie

6/25/2018 Gainey, Michelle

Garcia, Anthony Paul

2/26/2020 Garcia, Arlene

11/19/2019 Garcia, Carlos

Garcia, Heidi Marie

9/18/2020 Garcia, Jesus

5/30/2018 Garcia-Tafolla, Rosalia

6/15/2018 Garlington, Ryan

9/28/2017 Garnhart, Dwight

4/4/2017 Garro, Gregory

2/21/2017 Garrett, Sandra J.

6/12/2017 Garrett, Sara Lynn

3/20/2023 Garrett, Shanice

1/2/2019 Garza, Jerry

3/17/2021 Gasper, Patrick

5/11/2023 Gatus-Banks, Tara

9/13/2018 Gelnette-Gutierrez, Amy

5/27/2021 Genereux Counseling Services LLC

8/31/2020 Genereux, John

1/30/2019 George, Tiffany

5/26/2017 Geshick, Stephanie

8/6/2020 Giaimo Podiatry of Nebraska

5/4/2018 Gibbs, Goldy

9/28/2017 Gibbs, Tommy

1/24/2019 Gill, Norvele

6/15/2018 Gillott, Constance

NPI

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Provider Type Chore Chore

Sanction Type Termination

Effective Date

2/11/2018

Term Permanent

Termination 4/2/2018 Permanent

Prior to NPI Requirement

Physician

Exclusion

8/12/2021 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Personal Assistance Service Chore Chore

Companion and Personal Care Personal Assistance Service Chore Chore Personal Assistance Service Chore Chore Personal Assistance Service Personal Assistance Service Personal Assistance Service Chore

Termination 12/11/2012 Permanent

Exclusion

02/14/20 Permanent

Termination 5/30/2017 Permanent

Exclusion 12/15/2023 Permanent

Termination 3/22/2018 Permanent

Termination 2/19/2018 Permanent

Termination 1/16/2018 Permanent

Termination 5/13/2019 Permanent

Exclusion

2/25/2021 Permanent

Termination 2/19/2018 Permanent

Termination 2/19/2018 Permanent

Termination 11/26/2018 Permanent

Termination 10/23/2020 Permanent

Termination 3/6/2013 Permanent

1790792380

Physician

Termination 6/5/2018 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1528107075

Atypical Provider Type-NPI not issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Personal Assistance Service Chore

Personal Assistance Service Personal Assistance Service Personal Assistance Service

Chore Personal Assistance Service Personal Assistance Service

Chore Licensed Independent Mental Health

Practitioner AD Waiver

Chore Chore Personal Assistance Service PAS/CHORE Chore

Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination Termination

11/11/2017 Permanent 4/8/2009 Permanent 7/28/2016 Permanent 3/9/2017 Permanent 2/19/2018 Permanent 5/14/2017 Permanent 8/10/2020 Permanent 3/22/2018 Permanent 5/11/2011 Permanent 2/11/2020 Permanent 10/8/2019 Permanent 9/19/2012 Permanent 9/18/2020 Permanent 2/11/2018 Permanent 2/19/2018 Permanent 9/26/2017 Permanent

1013012350

Dentist

Termination 2/15/2017 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Chore Chore Personal Assistance Service Personal Assistance Service Chore Personal Assistance Service Chore

Termination Termination Termination Termination Termination Termination Termination

12/9/2016 Permanent 6/8/2017 Permanent 2/26/2023 Permanent 9/7/2018 Permanent 3/3/2021 Permanent 5/3/2023 Permanent 9/6/2018 Permanent

1649728379

Professional Clinic

Termination 10/11/2020 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Licensed Independent Mental Health Practitioner

Community Living Day Support

Personal Assistance Service

Exclusion Termination Termination

8/28/2020 Permanent 1/27/2019 Permanent 4/7/2017 Permanent

1811340417

Doctor of Podiatric Medicine

Termination 7/8/2020 Permanent

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Personal Assistance Service Community Living Day Support

Personal Assistance Service Personal Assistance Service

Termination 11/11/2017 Permanent Termination 9/5/2017 Permanent Termination 1/23/2019 Permanent Termination 2/19/2018 Permanent

End Date N/A N/A N/A N/A NA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A NA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

Reason for Action

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Updated: 12/21/2023

Date Added to

NMEP

Provider Name

5/13/2016 Gobel, Barbara

2/21/2017 Goldberg, Marvin E.

8/13/2021 Golden Group Solutions LLC

9/14/2018 Gomez, Delgadina Camilla

12/13/2023 Gonzalez, Mikaela

10/4/2017 Gonzalez, Zaira Portillo

5/7/2021 Gonzalez De Hernandez, Sara

10/31/2016 Good 2B Home

2/23/2015 Goodro, Marvin Kent

5/23/2016 Goodteacher-Halloway, Nicole

12/21/2023 Gordon, Malynda

12/27/2017 Gordon, Rose

10/4/2017 Gorman, Paula

8/8/2016 Gossett, Sandra D.

5/13/2016 Goudy, Natalie K.

9/22/2016 Gould, Lawanda (aka's Cook & Sherman)

5/4/2018 Graham, Nicole

3/24/2020 Graham, Montoya

Grant, Christina

5/15/2018 Gray, Amanda

10/4/2017 Grayson, Jewell

5/31/2018 Green, Keesha

12/31/2018 Greene, Sarah

9/27/2017 Greenfield, Kimberly

5/11/2023 Greer, Dynasty

10/29/2019 Gress, Jo Len

2/6/2018 Griffin, Jason

5/15/2018 Griffith, Carolyn D

9/14/2017 Grigg, Eddy Joe

10/4/2017 Grimaldo Alvarez, Sandra C

5/27/2016 Guest, Janice

7/1/2022 Gulizia, Justin

4/13/2018 Gurrola, Margarita

9/27/2017 Gurrola, Ruth

3/17/2021 Guyton, Renita

3/30/2016 Hagen, Kenneth

1/11/2018 Hale, Denise D.

10/11/2017 Haling, Nancy A

10/11/2017 Hall, Brandon K

1/24/2019 Hall, Christine

4/13/2018 Hall, Mary B

8/6/2020 Hallowell, Debra

10/31/2016 Halstead, Samantha Marie

6/15/2018 Ham, Kristina

10/4/2017 Hamilton, Sheila

12/8/2017 Hammer, Brenda

6/25/2018 Hamzah, Sama

1/2/2019 Hankins, Kelli

Harbour, Cherie

6/11/2014 Hardine, Rochelle

7/27/2020 Harger, Julina

NPI

1285858332

1275567562

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI not issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1720271182

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI not issued

1780668996

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI not issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1457754814

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

1346408846

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Atypical Provider Type-NPI Not Issued

Provider Type

Sanction Type

Licensed Independent Mental Health Termination Practitioner

Physician

Termination

Effective Date

3/4/2016

12/5/2016

Term Permanent Permanent

Chore

Termination 7/28/2021 Permanent

Personal Assistance Service

Exclusion

6/24/2018 Permanent

Chore/Companion/Personal Care

Termination 7/25/2023 Permanent

Chore

Termination 6/4/2017 Permanent

Chore

Termination 4/17/2021 Permanent

Personal Assistance Service

Termination 6/13/2016 Permanent

Personal Assistance Service

Termination 1/2/2015 Permanent

Chore

Termination 2/12/2016 Permanent

Companion and Personal Care

Exclusion 12/15/2023 Permanent

PAS/CHORE

Exclusion 11/30/2017 Permanent

Chore

Termination 6/4/2017 Permanent

Personal Assistance Service

Termination 6/28/2016 Permanent

Personal Assistance Service

Exclusion

2/29/2016 Permanent

Licensed Mental Health Practitioner Termination 6/27/2016 Permanent

Chore

Termination 11/11/2017 Permanent

Personal Assistance Service

Termination 3/11/2020 Permanent

Chore

Termination 2/17/2011 Permanent

Personal Assistance Service

Termination 1/13/2018 Permanent

Chore

Termination 6/4/2017 Permanent

Personal Assistance Service

Termination 1/21/2018 Permanent

Chore

Termination 8/27/2018 Permanent

Personal Assistance Service

Termination 5/30/2017 Permanent

Companion and Personal Care

Exclusion

5/1/2023 Permanent

Personal Assistance Service

Termination 10/11/2019 Permanent

Chore

Termination 11/4/2017 Permanent

Chore

Termination 1/13/2018 Permanent

Chore

Termination 7/15/2017 Permanent

Chore

Termination 6/4/2017 Permanent

Chore

Termination 3/28/2016 Permanent

Companion and Personal Care

Termination 6/9/2022 Permanent

Personal Assistance Service

Termination 12/2/2017 Permanent

Personal Assistance Service

Termination 5/30/2017 Permanent

Personal Assistance Service

Termination 2/23/2021 Permanent

Dentist

Termination 8/28/2015 Permanent

Personal Assistance Service

Termination 10/21/2017 Permanent

Personal Assistance Service

Termination 5/14/2017 Permanent

Chore

Termination 9/16/2017 Permanent

PAS/CHORE

Termination 1/23/2019 Permanent

Chore

Termination 12/2/2017 Permanent

Chore

Provisionally Licensed Mental Health Practitioner

Chore

Termination Termination Termination

8/6/2020 Permanent 9/8/2016 Permanent 2/19/2018 Permanent

Personal Assistance Service

Termination 6/4/2017 Permanent

Licensed Drug & Alcohol Counselor Termination 11/19/2017 Permanent

PAS/CHORE

Termination 3/22/2018 Permanent

Chore

Termination 9/7/2018 Permanent

Personal Assistance Service

Termination 6/24/2008 Permanent

Personal Assistance Service

Termination 7/31/2013 Permanent

Chore

Termination 7/10/2020 Permanent

End Date N/A N/A N/A N/A N/A N/A NA N/A N/A N/A NA N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

Reason for Action

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

Violation of NMAP Policy

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