JONATHAN CLARK (NPI# 1154415156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154415156 |
| Entity Type | Individual |
| Full Name | JONATHAN CLARK |
| Credential | M.D. |
| Practice Address |
109 Daniel Dr Danville KY 40422-2527 |
| Mailing Address |
Po Box 990 Danville KY 40423-0990 |
| Practice Telephone | 8592363361 |
| Practice Fax Number | 8592399484 |
| Mailing Telephone | 8592363361 |
| Mailing Fax Number | 8592399484 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2011-08-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | KY35658 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64015225 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790246270 | Jonathan Andrew Clark | Nurse Practitioner | 5042 12th Ave N, St Petersburg, FL 33710-6011 | 2019-03-27 |
| 1720573447 | Jonathan Clark | Specialist/Technologist | 1214 Highland Lake Cir, Decatur, GA 30033-3460 | 2018-06-25 |
| 1376033381 | Jonathan Clark | Psychologist | 150 Payson Rd, Chestnut Hill, MA 02467-3272 | 2018-05-15 |
| 1871046748 | Jonathan Clark | Acupuncturist | 1803 N Wickham Rd, Melbourne, FL 32935-8155 | 2016-07-27 |
| 1831563105 | Jonathan Michael Clark | Counselor | 1522b Gregg St, Philadelphia, PA 19115-4283 | 2015-11-23 |
| 1841696820 | Jonathan Clark | Specialist/Technologist | 14049 Scenic Hwy, Lookout Mountain, GA 30750-4100 | 2014-11-18 |
| 1932508165 | Jonathan Daniel Clark | Specialist/Technologist | 11306 County Line Rd, Madison, AL 35756-2011 | 2014-08-13 |
| 1851645717 | Jonathan Clark | Student in an Organized Health Care Education/Training Program | 206 Finley Forest Dr, Chapel Hill, NC 27517-8689 | 2012-10-30 |
| 1184682866 | Jonathan Scott Clark | Family Medicine | 1103 Dewey Ave, Poteau, OK 74953-4411 | 2006-05-03 |
| 1851740724 | Jonathan J Clark Jr. | Social Worker | 5901 E 7th St, Long Beach, CA 90822-5201 | 2016-06-10 |
| Street Address |
109 DANIEL DR |
| City | DANVILLE |
| State | KY |
| Zip Code | 40422-2527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609816826 | Barbara Ann Bern | Physician Assistant | 109 Daniel Dr, Danville, KY 40422-2527 | 2006-06-07 |
| 1669016572 | Emily Hines | Nurse Practitioner | 109 Daniel Dr, Danville, KY 40422-2527 | 2019-11-04 |
| 1417436221 | Emhfl, Inc. | Physician Assistant | 109 Daniel Dr, Danville, KY 40422-2527 | 2018-08-13 |
| 1245775428 | Mary N. Fuller | Nurse Practitioner | 109 Daniel Dr, Danville, KY 40422 | 2016-12-27 |
| 1720214489 | Virginia King Purdom | Family Medicine | 109 Daniel Dr, Danville, KY 40422-2527 | 2009-06-08 |
| 1003069519 | Gina M Alexander | Social Worker | 109 Daniel Dr, Danville, KY 40422-2527 | 2008-10-28 |
| 1083740377 | Michael Brennan Royalty | Emergency Medicine | 109 Daniel Dr, Danville, KY 40422-2527 | 2007-02-23 |
| 1487708533 | Ephraim Mcdowell Health Resource, Inc. | Nurse Practitioner | 109 Daniel Dr, Danville, KY 40422-2527 | 2007-01-23 |
| 1912091901 | Joan Arnold | Nurse Practitioner | 109 Daniel Dr, Danville, KY 40422-2527 | 2006-10-03 |
| 1013024280 | Vera S King | Nurse Practitioner | 109 Daniel Dr, Danville, KY 40422-2527 | 2006-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568098754 | Healthstat Onsite Clinic Centre College | Preventive Medicine | 851 West Walnut St, Danville, KY 40422 | 2020-03-19 |
| 1134772288 | Austin Simpson | Physician Assistant | 217 South 3rd Street, Danville, KY 40422 | 2019-07-18 |
| 1033677695 | Shannon Holland Erwin | Counselor | 475 W Main St Suite 160, Danville, KY 40422 | 2019-03-03 |
| 1225556871 | Fallon Michelle Carnes | Counselor | 106 Belinda Blvd., Danville, KY 40422 | 2017-09-05 |
| 1780124529 | Natasha Taylor | Counselor | 461 South 4th Street, Danville, KY 40422 | 2017-02-27 |
| 1184088890 | Elizabeth Love | Counselor | 108 Saint Josephs Ct, Danville, KY 40422 | 2016-04-08 |
| 1801274550 | Jeremy Tate Johnson | Specialist/Technologist | 1637 Perryville Rd., Boyle County High School, Danville, KY 40422 | 2015-05-14 |
| 1649602228 | Susan Hale Couzens | Dentist | 435 Whirlaway Dr, Danville, KY 40422 | 2013-08-06 |
| 1265751200 | William Paul Baas | Ophthalmology | 440 W. Martin L. King Blvd., Suite 100, Danville, KY 40422 | 2010-05-28 |
| 1780823666 | Karen Totsuka IIi | Speech-Language Pathologist | 642 Nth 3rd St, Danville, KY 40422 | 2009-02-17 |
| Find all providers in zip 40422 | ||||
| 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 |
|---|---|---|---|---|
| 1801431648 | Selena Michelle Richert | Family Medicine | 24359 Orange Hill Rd, Danville, OH 43014-9647 | 2019-11-15 |
| 1114309267 | Yi Ding | Family Medicine | 800 Memorial Dr Ste D, Danville, VA 24541-1680 | 2015-06-25 |
| 1285026062 | Kavita Tripathi | Family Medicine | 125 Executive Dr Ste H, Danville, VA 24541-4155 | 2015-03-03 |
| 1194139519 | Randy Michael Chan | Family Medicine | 109 Bridge St Ste 201, Danville, VA 24541-1222 | 2014-06-13 |
| 1225476120 | Natalie Alexander | Family Medicine | 201 South Main St., Suite 3200, Danville, VA 24541-2922 | 2013-06-13 |
| 1033472683 | Bayview Family Clinic - Danville | Family Medicine | 3595 N Vermilion St, Danville, IL 61832-1337 | 2012-06-19 |
| 1326322736 | Family Practice Medical Center | Family Medicine | 511 W. Fairchild Street, Danville, IL 61832 | 2011-10-04 |
| 1750566162 | Bashirahmed M Ameji | Family Medicine | 3820 East Main Street, Danville Correctional Center Medical Department, Danville, IL 61834-5796 | 2008-01-03 |
| 1134314602 | Provena Service Corporation | Family Medicine | 405 Sheridan St, Danville, IL 61832-4451 | 2007-09-07 |
| 1376743278 | Michael R Rousse | Family Medicine | 1301 Stannard Mtn Rd, Danville, VT 05828-4417 | 2007-07-19 |
| Find all providers in DANVILLE | ||||
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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.