JESSE KAY CLARK (NPI# 1043721129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043721129 |
| Entity Type | Individual |
| Full Name | JESSE KAY CLARK |
| Credential | PA |
| Practice Address |
800 5th Ave Ste 300 Fort Worth TX 76104-7303 |
| Practice Telephone | 8178785300 |
| Practice Fax Number | 8178785321 |
| Mailing Telephone | 8178785300 |
| Mailing Fax Number | 8178785321 |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2019-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA11698 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730517087 | Jesse Wayne Clark | Counselor | 65 Grady Ct, Dayton, OH 45409 | 2013-10-24 |
| 1699323931 | Jesse Clark | Occupational Therapy Assistant | 3485 Windsor Ave, Dubuque, IA 52001-1329 | 2019-08-29 |
| 1154642585 | Jesse N Clark | Family Medicine | 10122 E. 10th Street, Suite 100, Indianapolis, IN 46229-2697 | 2010-06-21 |
| 1811166572 | Jesse Lawton Clark | Internal Medicine | 5767 W Century Blvd, Suite 200, Los Angeles, CA 90045-5632 | 2008-02-27 |
| 1376729756 | Jesse D Clark | Dentist | 1611 Greenfield St, Wilmington, NC 28401-6455 | 2008-01-15 |
| Street Address |
800 5TH AVE STE 300 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-7303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376583906 | Stephanie Lynn Curtis | Physician Assistant | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2006-06-08 |
| 1528583762 | Kailey Richelle Osbaugh | Physician Assistant | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2017-08-09 |
| 1811361694 | Brooke Stovall | Physician Assistant | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2015-11-17 |
| 1952774580 | Meghan Leigh Bridges | Physician Assistant | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2015-11-04 |
| 1306212543 | Hajra Motiwala | Physician Assistant | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2015-08-11 |
| 1255710794 | Cassidy Rae Keshvani | Physician Assistant | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2015-05-28 |
| 1255776605 | Guadalupe De La Fuente Jr. | Orthopaedic Surgery | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2013-04-29 |
| 1982944922 | Melanie R Cobb | Physician Assistant | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2013-02-28 |
| 1780975045 | George Franklin Lebus V | Orthopaedic Surgery | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2011-04-21 |
| 1194041558 | Dean N Papaliodis | Orthopaedic Surgery | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2010-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447789896 | Texas Surgical Ally | Physician Assistant | 6677 Friendsway Dr, Fort Worth, TX 76137 | 2017-06-08 |
| 1831647734 | Frisco Neuro Collaborations, Pllc | Physician Assistant | 6387 Camp Bowie Blvd Ste B-640, Fort Worth, TX 76116 | 2016-09-20 |
| 1205299138 | Trasimeno, LLC | Physician Assistant | 9800 Sinclair St, Fort Worth, TX 76244-5890 | 2016-03-29 |
| 1770974727 | Melvin Johnson | Physician Assistant | 1016 Grand National Blvd, Fort Worth, TX 76179-2336 | 2015-02-12 |
| 1780924415 | Erica Valenzuela | Physician Assistant | 521 Darlington Trl, Fort Worth, TX 76131-3541 | 2013-02-16 |
| 1871746230 | Ansurio Cardona Jr. | Physician Assistant | 11800 Horseshoe Ridge Dr, Fort Worth, TX 76244-4892 | 2008-10-29 |
| 1548481781 | Henry Lee Collins | Physician Assistant | 2713 Clovermeadow Dr, Fort Worth, TX 76123-2107 | 2007-05-02 |
| 1376583906 | Stephanie Lynn Curtis | Physician Assistant | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2006-06-08 |
| 1992774103 | Sarah Rodriguez | Physician Assistant | 3637 Bellaire Dr S, Fort Worth, TX 76109-2135 | 2006-03-17 |
| 1811597321 | Kathryn Varano | Physician Assistant | 1250 8th Ave, Fort Worth, TX 76104-4124 | 2020-10-26 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on JESSE KAY CLARK.
| 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.