SHELBY CLARK (NPI# 1043863400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043863400 |
| Entity Type | Individual |
| Full Name | SHELBY CLARK |
| Credential | LAT, ATC |
| Practice Address |
4310 Appleby Sand Rd Nacogdoches TX 75965-2232 |
| Practice Telephone | 9365642466 |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2019-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT5794 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598179897 | Shelby Leigh Clark | Social Worker | 1211 N 8th St, Kansas City, KS 66101-2129 | 2014-06-13 |
| 1013540210 | Shelby Lynne Clark | Behavior Technician | 5402 Holly Rd Ste 2102, Corpus Christi, TX 78411-4673 | 2020-02-15 |
| 1215578539 | Shelby Clark | Behavior Technician | 5900 W Chester Rd Ste C, West Chester, OH 45069-2951 | 2019-10-08 |
| 1982257507 | Shelby Clark | Physician Assistant | 225 Crosslake Dr, Evansville, IN 47715-8198 | 2019-07-23 |
| 1942788815 | Shelby Linnette Clark | Massage Therapist | 1307 Violet St Se, Lacey, WA 98503-5710 | 2018-08-02 |
| 1023511409 | Shelby Lee Clark | Occupational Therapist | 205 Nolan Pkwy, Archbold, OH 43502-8404 | 2018-03-13 |
| 1013436518 | Shelby Clark | Technician | 400 N Pennsylvania Ave, Mangum, OK 73554-3034 | 2017-09-15 |
| Street Address |
4310 APPLEBY SAND RD |
| City | NACOGDOCHES |
| State | TX |
| Zip Code | 75965-2232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942853320 | Bryan Alford Trotty | Specialist/Technologist | 4310 Appleby Sand Rd, Nacogdoches, TX 75965-2299 | 2019-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649839135 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3824 N University Drive, Suite 103, Nacogdoches, TX 75965 | 2019-06-10 |
| 1518520493 | Billy Jobe | Pharmacist | 917 East Austin, Nacogdoches, TX 75965 | 2019-04-17 |
| 1295217610 | Sarah Ponder | Registered Nurse | 625 Woodway Lane, Nacogdoches, TX 75965 | 2018-09-01 |
| 1083107684 | Aakash Deep Gupta | Dentist | 4610 North St Ste 101b, Nacogdoches, TX 75965 | 2018-06-08 |
| 1679097455 | Emily Morris Taravella | Counselor | 3524 Ne Stallings Drive, Nacogdoches, TX 75965 | 2017-08-02 |
| 1457809949 | Kassey Osborn | Nurse Practitioner | 4920 Ne Stallings Dr., Nacogdoches Medical Center, Nacogdoches, TX 75965 | 2016-09-14 |
| 1629426747 | Lisa Greathouse | Technician, Other | 500 Chincapin, Westville, OK 75965 | 2016-05-31 |
| 1457741704 | Nuch of Texas | Pediatrics | 1305 North Street, Nacogdoches, TX 75965 | 2015-01-26 |
| 1730506031 | Benjamin Patrick Thompson | Obstetrics & Gynecology | 4800 Ne Stallings Dr Ste 106, Nacogdoches, TX 75965 | 2014-03-25 |
| 1255761813 | Kallie Krawietz | Counselor | 2214 N Pecan Street, Nacogdoches, TX 75965 | 2013-11-19 |
| Find all providers in zip 75965 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548894561 | Charnaa Dejean | Specialist/Technologist | 1602 Cardinal St Apt 1332b, Nacogdoches, TX 75961-4360 | 2020-02-28 |
| 1578195582 | Trevon Jerrell Jones | Specialist/Technologist | 13010 Sfa Station, Nacogdoches, TX 75961 | 2020-02-07 |
| 1487285896 | Alejandro Sandoval | Specialist/Technologist | 5222 Northway Dr, Nacogdoches, TX 75965-1440 | 2020-02-04 |
| 1841821253 | John Horn | Specialist/Technologist | 5222 Northway Dr Apt 105, Nacogdoches, TX 75965-1444 | 2020-02-04 |
| 1578194981 | Chance Andrew Evans | Specialist/Technologist | 4704 N University Dr Apt 314, Nacogdoches, TX 75965-2608 | 2020-02-04 |
| 1346895620 | Daniel Anthony Latourelle | Specialist/Technologist | 712 Hayter Street, Nacogdoches, TX 75962-0001 | 2019-08-05 |
| 1568026177 | Brianna Williams | Specialist/Technologist | 1602 Cardinal St Apt 622a, Nacogdoches, TX 75961-4339 | 2019-04-29 |
| 1497250450 | Aubrey Elyse Laurent | Specialist/Technologist | 5623 County Road 817, Nacogdoches, TX 75964 | 2018-03-29 |
| 1275081051 | Kira Rubin | Specialist/Technologist | Sfa Athletic Fieldhouse, 712 Hayter St, Nacogdoches, TX 75962-0001 | 2016-09-21 |
| 1508313677 | Melinda Watts | Specialist/Technologist | 1936 North Street Hpe Complex, Nacogdoches, TX 75962-3703 | 2016-09-07 |
| Find all providers in NACOGDOCHES | ||||
| City | NACOGDOCHES |
| Zip Code | 75965 |
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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.