MICHELLE B CLARK (NPI# 1063914109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063914109 |
| Entity Type | Individual |
| Full Name | MICHELLE B CLARK |
| Other Name | MICHELLE M BERCH |
| Practice Address |
17809 Pierce Plz Omaha NE 68130-1035 |
| Mailing Address |
8200 Dodge St Omaha NE 68114-4113 |
| Practice Telephone | 4029558355 |
| Practice Fax Number | 4029558356 |
| Mailing Telephone | 4029555400 |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2018-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
3652 | NE | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568078947 | Michelle Jean Clark | Counselor | 318 S Welborn St Ste C, Hinesville, GA 31313-3127 | 2020-09-21 |
| 1790335651 | Michelle Clark | Home Health Aide | 1794 E 87th St, Cleveland, OH 44106 | 2019-09-12 |
| 1215488168 | Michelle Allison Clark | Nurse Practitioner | 413 Glenbrook Rd, 9, Stamford, CT 06906-2126 | 2016-10-16 |
| 1174995120 | Michelle Annette Clark | Massage Therapist | 1935 S I St Apt A, Apt A, Tacoma, WA 98405-3879 | 2015-10-28 |
| 1518347095 | Michelle Marie Clark | Allergy & Immunology | 1600 Rockland Rd Ste 3d16, Wilmington, DE 19803 | 2015-06-01 |
| 1245620822 | Michelle Clark | Technician, Other | 715 Briar Hill Ln, Saginaw, MI 48609-5005 | 2015-02-03 |
| 1578987533 | Michelle Clark | Kinesiotherapist | 4573 Normandie Pl, La Mesa, CA 91942-8502 | 2014-02-12 |
| 1457624686 | Michelle Clark | Occupational Therapist | 6276 Jackie Ave, Woodland Hills, CA 91367-1422 | 2012-02-19 |
| 1922302967 | Michelle Clark | Occupational Therapist | 1930 Circle of Hope Dr Fl 2, Salt Lake City, UT 84132-0001 | 2011-01-05 |
| 1972813517 | Michelle Ann Clark | Marriage & Family Therapist | 10904 57th St Ne Ste 106, Albertville, MN 55301-4654 | 2010-10-18 |
| Street Address |
17809 PIERCE PLZ |
| City | OMAHA |
| State | NE |
| Zip Code | 68130-1035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487988119 | Children's Rehab Physical Therapy | Physical Therapist | 17809 Pierce Plz, Children's Rehab - Physical Therapy, Omaha, NE 68130-1035 | 2009-09-29 |
| 1063955789 | Samantha A Sibson | Speech-Language Pathologist | 17809 Pierce Plz, Children's Rehab - Speech Therapy, Omaha, NE 68130-1035 | 2016-11-29 |
| 1184075806 | Kimberly Booras | Occupational Therapist | 17809 Pierce Plz, Children's Rehab - Physical Therapy, Omaha, NE 68130-1035 | 2016-06-23 |
| 1316397631 | Kelli M Eihusen | Physical Therapist | 17809 Pierce Plz, Children's Hospital & Medical Center, Omaha, NE 68130-1035 | 2016-06-17 |
| 1649630054 | Kayla M Brown | Speech-Language Pathologist | 17809 Pierce Plz, Children's Rehab Speech Therapy, Omaha, NE 68130-1035 | 2016-02-26 |
| 1295195691 | Abbie M Nelson | Occupational Therapist | 17809 Pierce Plz, Children's Rehab Occupational Therapy, Omaha, NE 68130-1035 | 2016-02-26 |
| 1093175580 | Carissa L Rowberry | Physical Therapist | 17809 Pierce Plz, Children's Rehab Physical Therapy, Omaha, NE 68130-1035 | 2016-02-26 |
| 1124488531 | Audra Nelson | Speech-Language Pathologist | 17809 Pierce Plz, Children's Rehab Speech Therapy, Omaha, NE 68130-1035 | 2016-02-26 |
| 1255791653 | Sarah A Depalma | Speech-Language Pathologist | 17809 Pierce Plz, Children's Rehab Speech Therapy, Omaha, NE 68130-1035 | 2016-02-26 |
| 1003140732 | Children's Rehab - Occupational Therapy | Occupational Therapist | 17809 Pierce Plz, Children's Rehab - Occupational Therapy, Omaha, NE 68130-1035 | 2009-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861998270 | Samantha June Curto | Nurse Practitioner | 17021 Lakeside Drive, Suite 200, Omaha, NE 68130 | 2018-04-04 |
| 1780196451 | Heritage Oncare Home Health LLC | Home Health | 16934 Frances St Ste 200, Omaha, NE 68130 | 2017-11-02 |
| 1497281745 | Dental Professionals of Nebraska, PC | Dentist | 17810 Pierce Plaza, Suite 100, Omaha, NE 68130 | 2017-05-05 |
| 1891166492 | Stephanie Tupper | Speech-Language Pathologist | 16338 Oak Circle, Omaha, NE 68130 | 2015-10-08 |
| 1194036723 | Anthony John Macdissi | Internal Medicine | 16901 Lakeside Hills Court, Attn: Hospital Medicine Dept., Omaha, NE 68130 | 2010-06-29 |
| 1568613305 | Kelly Marie Barkmeier | Occupational Therapist | 1906 South 196th Street, Omaha, NE 68130 | 2008-10-09 |
| 1306009758 | Melissa Sue Loseke | Family Medicine | 17021 Lakeside Hills Plz #200, Omaha, NE 68130 | 2008-07-07 |
| 1477724417 | Denise L. Pollard | Nurse Practitioner | 17525 Gold Plaza Ste 116, Omaha, NE 68130 | 2008-03-18 |
| 1508053943 | Omaha Family Medicine, P.C. | Family Medicine | 17841 Pierce Plz, Omaha, NE 68130 | 2007-10-01 |
| 1669672523 | Jennifer L Liu | Family Medicine | 16909 Lakeside Hills, Ste 300, Omaha, NE 68130 | 2007-07-19 |
| Find all providers in zip 68130 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841666831 | Margo Lutes | Physical Therapist | 444 S 44th Street, Omaha, NE 68198-4984 | 2015-08-13 |
| 1962791962 | Mary E Kouba | Physical Therapist | 14705 W Plz, Omaha, NE 68137-2518 | 2011-03-31 |
| 1477888246 | Shireen D'ann Hauser-miller | Physical Therapist | 13336 Industrial Rd Ste 101, Omaha, NE 68137-1124 | 2009-10-12 |
| 1487988119 | Children's Rehab Physical Therapy | Physical Therapist | 17809 Pierce Plz, Children's Rehab - Physical Therapy, Omaha, NE 68130-1035 | 2009-09-29 |
| 1093323867 | Chelsea Silva | Physical Therapist | 3516 N 163rd Plz, Omaha, NE 68116-2106 | 2020-07-17 |
| 1639710874 | Samantha M Rezab | Physical Therapist | 8200 Dodge St, Omaha, NE 68114-4113 | 2019-09-30 |
| 1811545296 | Kassi Sue Williams | Physical Therapist | 10824 Old Mill Rd Ste 10-1, Omaha, NE 68154-2642 | 2019-08-29 |
| 1316397631 | Kelli M Eihusen | Physical Therapist | 17809 Pierce Plz, Children's Hospital & Medical Center, Omaha, NE 68130-1035 | 2016-06-17 |
| 1093175580 | Carissa L Rowberry | Physical Therapist | 17809 Pierce Plz, Children's Rehab Physical Therapy, Omaha, NE 68130-1035 | 2016-02-26 |
| 1568835114 | Kelly Denise Ealy | Physical Therapist | 5606 S 147th St, Omaha, NE 68137-2648 | 2015-11-04 |
| Find all providers in OMAHA | ||||
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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.