CARLIE CLARK (NPI# 1114383122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114383122 |
| Entity Type | Individual |
| Full Name | CARLIE CLARK |
| Credential | ATC, LAT, CES |
| Practice Address |
725 University Blvd Dayton OH 45435-0001 |
| Mailing Address |
1206 Dickens Dr Apt A Fairborn OH 45324-8790 |
| Practice Telephone | 9372457559 |
| Practice Fax Number | 9374250736 |
| Mailing Telephone | 6142034805 |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT.003570 | OH | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
725 UNIVERSITY BLVD |
| City | DAYTON |
| State | OH |
| Zip Code | 45435-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114920329 | Wright State Physicians Inc | Dermatology | 725 University Blvd, Dayton, OH 45435-0001 | 2005-05-23 |
| 1609405638 | Emily Albanese | Specialist/Technologist | 725 University Blvd, Dayton, OH 45435-0001 | 2020-04-02 |
| 1184128969 | Sally Jane Trout | Specialist/Technologist | 725 University Blvd, Dayton, OH 45435-0001 | 2018-03-19 |
| 1023481108 | Kelsey Scuderi | Nurse Practitioner | 725 University Blvd, Dayton, OH 45435-0001 | 2015-11-11 |
| 1700256096 | Wright State University | Specialist/Technologist | 725 University Blvd, Dayton, OH 45435-0001 | 2015-09-30 |
| 1336528256 | Kyra Dorney | Specialist/Technologist | 725 University Blvd, Dayton, OH 45435-0001 | 2015-05-26 |
| 1326473851 | Christen Michelle Richardson | Physician Assistant | 725 University Blvd, Dayton, OH 45435-2939 | 2013-09-03 |
| 1164869368 | Amber Elizabeth Smith | Physical Therapy Assistant | 725 University Blvd, Dayton, OH 45435-0001 | 2013-05-29 |
| 1154677631 | Wright Health Inc | Pharmacy | 725 University Blvd, 2nd Floor, Dayton, OH 45435-0001 | 2012-08-02 |
| 1205197985 | Wright State Physicians Inc | Dermatology | 725 University Blvd, Dayton, OH 45435-0001 | 2012-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538706940 | Anthony Kelemen | Student in an Organized Health Care Education/Training Program | Sopp At Wright State University, 117 Health Sci Bldg, 3640 Colonel Glenn Hwy, Dayton, OH 45435 | 2019-12-04 |
| 1801444955 | Ashley Elizabeth Murphy | Student in an Organized Health Care Education/Training Program | Wsu School of Professional Psychology, 3640 Colonel Glenn Hwy, 117 Health Sciences Bldg, Dayton, OH 45435 | 2019-09-02 |
| 1659854370 | Rachel Heckaman | Student in an Organized Health Care Education/Training Program | Sopp Wright State Univerity 117 Health Science Bldg., 3640 Colonel Glenn Hwy, Dayton, OH 45435 | 2018-09-09 |
| 1508374547 | Somer Leanne Yoho | Student in an Organized Health Care Education/Training Program | 117 Health Sciences Building, 3640 Colonel Glenn Hwy, Dayton, OH 45435 | 2018-01-11 |
| 1689180622 | Jerie Johanna Bolin | Student in an Organized Health Care Education/Training Program | 117 Health Sciences Bldg, 3640 Colonel Glenn Hwy, Dayton, OH 45435 | 2017-12-28 |
| 1578079810 | Heather Ann Felerski | Student in an Organized Health Care Education/Training Program | 117 Health Sciences Bldg., 3640 Colonel Glenn Hwy., Dayton, OH 45435 | 2017-12-22 |
| 1154771392 | Abigail Ngayan | Counselor | 3640 Colonel Glenn Hwy., 053 Student Union, Dayton, OH 45435 | 2016-06-19 |
| 1144512799 | Adam Horseman | Specialist/Technologist | 3640 Col. Glenn Hwy., Room 356 Nutter Center, Dayton, OH 45435 | 2011-05-13 |
| 1790999589 | Luis Tony Ortiz | Specialist/Technologist | 3640 Colonel Glen Hwy, Room 303 Nutter Center, Dayton, OH 45435 | 2007-05-10 |
| 1164037446 | Jaden D Johnson | Student in an Organized Health Care Education/Training Program | 3640 Colonel Glenn Hwy., 117 Health Sciences Bldg, Dayton, OH 45435 | 2020-09-13 |
| Find all providers in zip 45435 | ||||
| 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 |
|---|---|---|---|---|
| 1750912168 | Daniel Wyatt Deloney | Specialist/Technologist | 517 Ripkowski Dr, Dayton, TX 77535-2879 | 2020-02-04 |
| 1891351706 | Noel Cain | Specialist/Technologist | 323 Great Oaks Dr, Dayton, OH 45403-2858 | 2019-05-15 |
| 1154888337 | Anne Marie Paquette | Specialist/Technologist | 291 Meyer Ave, Dayton, OH 45431-1975 | 2019-02-25 |
| 1154888394 | Arkeylah Metcalf | Specialist/Technologist | 6218 Cheri Lynne Dr, Dayton, OH 45415-2107 | 2019-02-25 |
| 1861958407 | Kaylie Holland | Specialist/Technologist | 3605 Se Locks Rd, Dayton, OR 97114-7035 | 2019-02-19 |
| 1023582442 | Sydney Nicole Numbers | Specialist/Technologist | 6429 Rosa Linda Dr, Dayton, OH 45459-2866 | 2019-01-18 |
| 1750863387 | Madison Ames | Specialist/Technologist | 4105 Marianne Dr, Dayton, OH 45404-1370 | 2018-08-30 |
| 1093297624 | Carl Denver De Guzman | Specialist/Technologist | 1414 Captains Brg, Dayton, OH 45458-5705 | 2018-08-30 |
| 1548760895 | Robert Allen Holsinger Jr. | Specialist/Technologist | 3200 N Cleveland St, Dayton, TX 77535-2306 | 2018-02-13 |
| 1316465123 | Antonio Carter | Specialist/Technologist | 1255 Westbrook Rd, Dayton, OH 45415-1903 | 2017-08-31 |
| Find all providers in DAYTON | ||||
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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.