ROBERT CLARK (NPI# 1104112788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104112788 |
| Entity Type | Individual |
| Full Name | ROBERT CLARK |
| Credential | FNP |
| Practice Address |
101 E Wt Harris Blvd Bldg 5000 Suite #5101 Charlotte NC 28262-3485 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 7048635847 |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2020-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 5005238 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 E Wt Harris Blvd, Bldg 5000, Suite #5101, Charlotte, NC 282623485 | 7048635847 | |
| 1350 S Kings Dr, Charlotte, NC 282072134 | 7044461242 | |
| 1350 S Kings Dr, Charlotte, NC 282072134 | 7044464490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457989048 | Robert William Clark | Registered Nurse | 1511 Se 16th Ave, Ocala, FL 34471-4627 | 2020-03-30 |
| 1578012225 | Robert Clark | Technician, Other | 5075 Belmere Dr, Manitou Beach, MI 49253-9626 | 2016-09-22 |
| 1447535620 | Robert Leal Clark | Ophthalmology | 901 Forest Ave., Johnson City, TN 37601 | 2011-10-19 |
| 1619287216 | Robert Earl Clark | Occupational Therapist | 6623 N Main St, Davenport, IA 52806 | 2010-10-15 |
| 1376778746 | Robert T Clark Sr. | Chiropractor | 2411 Us Highway 27 S, Sebring, FL 33870-4943 | 2009-05-28 |
| 1538358924 | Robert Coleman Clark | Massage Therapist | 1501b Grape St, Tallahassee, FL 32303-5637 | 2007-10-22 |
| 1376765925 | Robert Clark | Nurse Practitioner | Employee and Occupational Health, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2007-05-03 |
| 1396963666 | Robert Clark | Licensed Practical Nurse | 26347 Lake Lindsey Rd, Brooksville, FL 34601-4304 | 2007-04-23 |
| 1770708349 | Robert Douglas Clark | Physical Therapist | 3580 Discovery Dr, Grove City, OH 43123-9329 | 2007-04-17 |
| 1053432633 | Robert Joseph Clark | Dentist | 5323 Brainerd Rd Ste 105, Chattanooga, TN 37411-5305 | 2007-04-02 |
| Street Address |
101 E WT HARRIS BLVD BLDG 5000 SUITE #5101 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28262-3485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518962711 | Nancy Colette Montz | Specialist | 101 E Wt Harris Blvd, Suite 5002, Charlotte, NC 28262-3485 | 2005-06-15 |
| 1275099152 | Daina Worcester | Nurse Practitioner | 101 E Wt Harris Blvd, Building 1000 Ste 1110, Charlotte, NC 28262-3485 | 2019-02-15 |
| 1083197446 | Anna Caldwell | Nurse Practitioner | 101 E Wt Harris Blvd, Building 1000 Suite 1110, Charlotte, NC 28262-3485 | 2018-09-12 |
| 1609360239 | Tyesha Harvey | Nurse Practitioner | 101 E Wt Harris Blvd, Building 1000 Ste 1110, Charlotte, NC 28262-3485 | 2018-06-18 |
| 1366945990 | Erika Fink | Nurse Practitioner | 101 E Wt Harris Blvd, Ste 5002, Charlotte, NC 28262-3485 | 2018-03-09 |
| 1053813105 | Jacqueline Wichern | Nurse Practitioner | 101 E Wt Harris Blvd, Building 1000 Suite 1110, Charlotte, NC 28262-3485 | 2018-03-05 |
| 1215456546 | Paige Hayes | Physician Assistant | 101 E Wt Harris Blvd, Building 1000 Suite 1110, Charlotte, NC 28262-3485 | 2017-09-19 |
| 1194267815 | Jordan Brittle | Physician Assistant | 101 E Wt Harris Blvd, Building 1000 Ste 1110, Charlotte, NC 28262-3485 | 2016-11-11 |
| 1538610589 | Chadwick Smith | Nurse Practitioner | 101 E Wt Harris Blvd, Building 1000 Ste 1110, Charlotte, NC 28262-3485 | 2016-10-14 |
| 1932658697 | Jonathan Lowe | Nurse Practitioner | 101 E Wt Harris Blvd, Bldg 5000 Suite #5101, Charlotte, NC 28262-3485 | 2016-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056913 | Aleta Michelle Johnson | Specialist | 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 | 2020-09-01 |
| 1275161580 | Londyn Homecare Agency L.l.c | Home Health | 1914j.n. Place, Charlotte, NC 28262 | 2020-03-31 |
| 1154964914 | Abundant Love Home Care Service LLC | In Home Supportive Care | 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 | 2019-10-24 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1114404506 | Laura Ida Anthony-getant | Social Worker | 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 | 2018-07-27 |
| 1720573587 | Carolinas Center for Ambulatory Dentistry LLC | Dentist | 8415 Medical Plaza Drice, Charlotte, NC 28262 | 2018-06-25 |
| 1598254799 | Cassandra Faye Harding | Nurse Practitioner | 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 | 2018-05-03 |
| 1669960746 | Michael Riley | In Home Supportive Care | 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 | 2018-04-25 |
| 1568989804 | Bridget Coomber | Behavior Technician | 8420 University Executive Dr Ste 810, Charlotte, NC 28262 | 2017-08-28 |
| 1073037701 | Toshana Daley | Physical Therapist | 8801 Jm Keynes Blvd, Charlotte, NC 28262 | 2017-08-03 |
| Find all providers in zip 28262 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544986 | Tonya Lynn Burris | Nurse Practitioner | 7810 Providence Rd Ste 102, Charlotte, NC 28226-2987 | 2020-09-28 |
| 1003428293 | Kashari Davis | Nurse Practitioner | 4252 Sutwick Dr, Charlotte, NC 28269-6001 | 2020-08-19 |
| 1457972796 | Lindsey O'brien | Nurse Practitioner | 3423 Hornets Nest Way, Charlotte, NC 28208-5224 | 2020-04-28 |
| 1285254904 | Barbara Ballard | Nurse Practitioner | 10731 Haddington Dr Nw, Charlotte, NC 28269-6954 | 2020-04-22 |
| 1710506787 | Lindsey Delcasino Plair | Nurse Practitioner | 1212 South Blvd, Charlotte, NC 28203-4215 | 2020-04-10 |
| 1457991275 | Advanced Physical Medicine | Nurse Practitioner | 8821 University East Dr # 120, Charlotte, NC 28213-4200 | 2020-01-09 |
| 1700447562 | Milford Darnell George Jr. | Nurse Practitioner | 8403 University Executive Park Drive, Suite 685, Charlotte, NC 28262-3330 | 2019-06-24 |
| 1194288241 | Tonya Denise Farmer | Nurse Practitioner | 620 Tom Hunter Road, Charlotte, NC 28213 | 2019-04-06 |
| 1649738204 | Brittany Schmalfeld | Nurse Practitioner | 8943 S Tryon St Unit K, Charlotte, NC 28273-3539 | 2019-03-03 |
| 1407313703 | Natalie Ann Bullock | Nurse Practitioner | 400 E Stonewall St Ste F, Charlotte, NC 28202-3601 | 2019-02-23 |
| Find all providers in CHARLOTTE | ||||
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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.