JACOB EARL CLARK (NPI# 1093206773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093206773 |
| Entity Type | Individual |
| Full Name | JACOB EARL CLARK |
| Credential | MS, AT, NR-EMT |
| Practice Address |
116 S Lane St Blissfield MI 49228-1206 |
| Mailing Address |
3503 Willow Brook Ln Toledo OH 43611-3018 |
| Practice Telephone | 5174865278 |
| Mailing Telephone | 4199065086 |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2019-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| D232 County Road 18, Holgate, OH 435279796 | 4199065086 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760049068 | Jacob David Clark | Optometrist | 4800 Whitesburg Dr Sw, Huntsville, AL 35802-1698 | 2019-05-22 |
| 1437512613 | Jacob Tyler Clark | Emergency Medicine | 1035 Kepler Dr, Green Bay, WI 54311-8320 | 2016-04-04 |
| 1164464806 | Jacob A Clark | Ophthalmology | 411 N Washington St, Alexandria, VA 22314-2311 | 2006-06-10 |
| 1003864620 | Jacob Scott Clark | Chiropractor | 854c Kaliste Saloom Rd, Lafayette, LA 70508-4210 | 2006-05-05 |
| 1629695663 | Jacob Alan Clark | Specialist/Technologist | 101 College Hts, Cisco, TX 76437-1900 | 2020-06-25 |
| 1205468006 | Jacob C Clark | Occupational Therapy Assistant | 7800 W Outer Dr Ste 300, Detroit, MI 48235-3458 | 2020-02-10 |
| 1093282410 | Jacob Zachary Clark | Nurse Anesthetist, Certified Registered | 3705 Medical Pkwy Ste 570, Austin, TX 78705-1024 | 2018-10-24 |
| 1568956621 | Jacob Clark | Dentist | 203 S Cherry St, Greenville, KY 42345-1225 | 2018-06-21 |
| 1487009957 | Jacob Clark | Technician, Other | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2016-05-03 |
| 1871735167 | Jacob Andrew Clark | Anesthesiology | 41 Mall Rd, Lahey Hospital and Medical Center, Burlington, MA 01805-0001 | 2009-04-01 |
| Street Address |
116 S LANE ST |
| City | BLISSFIELD |
| State | MI |
| Zip Code | 49228-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861782203 | Emily Theresa Louise Quinton | Physical Therapist | 116 S Lane St, Blissfield, MI 49228-1206 | 2011-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386835999 | Great Lakes Family Dental Group Blissfield PC | Dentist | 9178 E Us 223, Great Lakes Family Dental Group Blissfield PC, Blissfield, MI 49228 | 2007-08-08 |
| 1932223344 | Linda Yarick Yarick | Counselor | 25 S Monroe, Monroe, MI 49228 | 2007-03-19 |
| 1316073703 | Promedica Corporation of Michigan | Family Medicine | 9205 East Us Highway 23, Blissfield, MI 49228 | 2007-02-27 |
| 1235214495 | Ella M Noel | Internal Medicine | 157 West Brooke Lane, Blissfield, MI 49228 | 2006-10-26 |
| 1518341098 | Maura Ann Crescenzo | Nurse Practitioner | 157 W Brooke Ln, Blissfield, MI 49228 | 2015-07-15 |
| 1346607611 | Renae Sauter | Occupational Therapist | 403 W Adrian St, Blissfield, MI 49228-1001 | 2016-01-18 |
| 1871150912 | Amanda Suzanna Koyl | Pharmacist | 616 W Adrian St, Blissfield, MI 49228-1005 | 2019-05-23 |
| 1417013269 | Gretchen Herzburg Boyd | Counselor | 115 N Main Street, Blissfield, MI 49228-1033 | 2006-12-28 |
| 1427665439 | Baruch Sls, Inc. | Assisted Living Facility | 301 N Quick St, Blissfield, MI 49228-1051 | 2020-09-24 |
| 1861808768 | Amy Descombes | Registered Nurse | 107 1/2 W Adrian St, Blissfield, MI 49228-1201 | 2014-07-11 |
| Find all providers in zip 49228 | ||||
| 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 |
|---|---|---|---|---|
| 1467052027 | Brianna Redmond | Specialist/Technologist | 2145 Sunset Ln, Saginaw, MI 48604-2443 | 2020-10-31 |
| 1386243913 | Carrie A Lindsay | Specialist/Technologist | 4761 Highland Rd, Waterford, MI 48328-1178 | 2020-10-24 |
| 1528667128 | Bethany Lynn York | Specialist/Technologist | 1461 Crest Rd, Gladwin, MI 48624-7606 | 2020-10-23 |
| 1255930962 | Benjamin Foddrill | Specialist/Technologist | 7380 Clearview Dr, Caledonia, MI 49316-9309 | 2020-10-22 |
| 1427656040 | Travis Zaborowski | Specialist/Technologist | 2412 W 4th Ave, Sault Sainte Marie, MI 49783-1212 | 2020-10-15 |
| 1730787912 | Batoul Kassem | Specialist/Technologist | 6045 Steadman St, Dearborn, MI 48126-2052 | 2020-10-11 |
| 1801493697 | Janelle Dorsey | Specialist/Technologist | 24311 Ithaca St, Oak Park, MI 48237-1788 | 2020-10-05 |
| 1194332379 | Bryan Keith Baines Sr. | Specialist/Technologist | 4333 John R Rd, Troy, MI 48085-3681 | 2020-09-30 |
| 1205443553 | Emma Weber | Specialist/Technologist | 7776 Percheron St, Kalamazoo, MI 49009-5990 | 2020-09-29 |
| 1295342616 | Margaret Ann Gilbeau | Specialist/Technologist | 38051 Metro Villa Dr Unit 114f, Harrison Township, MI 48045-3553 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
| City | BLISSFIELD |
| Zip Code | 49228 |
Please comment or provide details below to improve the information on JACOB EARL 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.