DONALD WAYNE CLARK (NPI# 1083773931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083773931 |
| Entity Type | Individual |
| Full Name | DONALD WAYNE CLARK |
| Credential | MD |
| Practice Address |
801 Vassar Ne Albuquerque Indian Health Center Albuquerque NM 87106 |
| Mailing Address |
801 Vassar Ne Albuquerque Indian Health Clinic Albuquerque NM 87106 |
| Practice Telephone | 5052484065 |
| Practice Fax Number | 5052484093 |
| Mailing Telephone | 5052484065 |
| Mailing Fax Number | 5052484093 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2010-12-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 96216 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 05679079 | 05 | |
| PRESBYTERIAN HEALTH PLAN | 13026 | 01 | |
| NM | MEDICARE PART B | HSZ196 | 01 |
| NM | K3526 | 05 | |
| LOVELACE SALUD | 2618 | 01 | |
| NM | MEDICARE GROUP PTAN | HSZ162 | 01 |
| NM | S5748 | 05 | |
| AZ | 723553 | 05 | |
| NM | MEDICARE PTAN | 8HZ91W | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710391875 | Donald Callan Clark | Anesthesiology | 7585 El Paso St, La Mesa, CA 91942-4302 | 2014-06-17 |
| 1124282538 | Donald Eugene Clark | Community Health Worker | 5117 Tarrywood Ln, Charlotte, NC 28205-4827 | 2008-07-15 |
| 1437278942 | Donald C Clark | Chiropractor | 4660 Slater Rd Ste 140, Eagan, MN 55122-4049 | 2007-03-28 |
| 1386669570 | Donald Godfrey Clark | Internal Medicine | 29521 Ford Rd, Garden City, MI 48135 | 2006-07-12 |
| 1487635132 | Donald L Clark | Psychologist | 428 Coffey Knob Rd, Boone, NC 28607-6608 | 2005-11-09 |
| 1366090573 | Donald Lee Clark IIi | Nurse Practitioner | 2100 Madison Ave, Granite City, IL 62040-4713 | 2019-08-30 |
| 1023588423 | Donald James Clark | Counselor | 100 New Salem Rd Ste 116, Uniontown, PA 15401-8936 | 2018-11-28 |
| 1447659701 | Donald Clark | Pharmacist | 6725 Dick Flynn Blvd, Goshen, OH 45122-8025 | 2014-08-22 |
| 1891102810 | Donald Keith Clark | Case Manager/Care Coordinator | 1351 Newtown Pike, Lexington, KY 40511-1275 | 2014-07-22 |
| 1699057943 | Donald Patrick Clark Jr. | Pharmacist | 1475 Dixie Hwy, Louisville, KY 40210-1767 | 2011-09-13 |
| Street Address |
801 VASSAR NE ALBUQUERQUE INDIAN HEALTH CENTER |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679808 | Jorge Licano | Student in an Organized Health Care Education/Training Program | Unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-04 |
| 1730780032 | Joseph Sanchez | Student in an Organized Health Care Education/Training Program | (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-03 |
| 1336746205 | Evan Laub | Pharmacist | 2950 Central Ave. Sw, Albuquerque, NM 87106 | 2020-10-05 |
| 1487203154 | Theresa Martinez | Technician | 5680 Avedon Dr. Se, Albuquerque, NM 87106 | 2019-09-05 |
| 1205300647 | Louis Mayer II | Specialist/Technologist | 1414 University Blvd Tow Diehm Athletic Facility, Albuquerque, NM 87106 | 2019-01-18 |
| 1235633355 | Terrena Grace Vigil Brady | Occupational Therapist | 1001 Yale Blvd, Albuquerque, NM 87106 | 2018-03-22 |
| 1205355195 | Yaritza Ruiz | Specialist/Technologist | 1200 Avenida Cesar Chavez, 231d, Albuquerque, NM 87106 | 2017-09-12 |
| 1457873382 | Cynthia Bluhm | Registered Nurse | 7600 Cedar St Se Ste 7600, Albuquerque, NM 87106 | 2017-07-12 |
| 1295265882 | Hallie Chancellor | Behavior Technician | 1801 Gibson Blvd Se Apt 1046, Albuquerque, NM 87106 | 2017-06-15 |
| 1780111757 | Jiana Hook | Physical Medicine & Rehabilitation | 1414 University Blvd. Se, Albuquerque, NM 87106 | 2017-05-22 |
| Find all providers in zip 87106 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063027696 | Comprehensive Gastrostomy Tube Cares, LLC | Family Medicine | 8100 Wyoming Blvd Ne Ste M4-701, Albuquerque, NM 87113-1946 | 2020-09-10 |
| 1740898428 | Dr. Maggie Wilson, PC | Family Medicine | 717 Encino Pl Ne Ste 5, Albuquerque, NM 87102-2624 | 2020-07-17 |
| 1831734813 | Leandra Lee Medina | Family Medicine | 7050 Barstow St Ne Ste B, Albuquerque, NM 87111-1056 | 2019-11-13 |
| 1093374589 | Palliative and Transitional Care of Nm LLC | Family Medicine | 805 Guadalupe Cir Nw, Albuquerque, NM 87114-1710 | 2019-06-10 |
| 1649834904 | Mederi Life LLC | Family Medicine | 4325 Carlisle Blvd Ne Ste B, Albuquerque, NM 87107-4826 | 2019-04-23 |
| 1649733619 | Susan Giron | Family Medicine | 6704 Baker Ave Ne, Albuquerque, NM 87109-2746 | 2019-04-08 |
| 1982163267 | Nm Spirit of Wellness LLC | Family Medicine | 123 Girard Blvd Se, Albuquerque, NM 87106-2227 | 2019-03-18 |
| 1891266458 | Karen Ann Longenecker | Family Medicine | 2300 Menaul Blvd Ne Fl 3, Albuquerque, NM 87107-1851 | 2018-12-07 |
| 1144797135 | Erin Aleisha Langford | Family Medicine | 4588 Paradise Blvd Nw # 100, Albuquerque, NM 87114-4105 | 2018-10-28 |
| 1740761972 | Maria Marcela Colom Bickford | Family Medicine | Msc 09-5040 I University of New Mexico, Albuquerque, NM 87131 | 2018-08-26 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87106 |
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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.