JONATHAN CLARK (NPI# 1164415204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164415204 |
| Entity Type | Individual |
| Full Name | JONATHAN CLARK |
| Practice Address |
1200 E Woodhurst Dr Suite Q-200 Springfield MO 65804-4257 |
| Practice Telephone | 4178815639 |
| Practice Fax Number | 4178815664 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD101561 | MO | Allopathic & Osteopathic Physicians |
| 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 |
1200 E WOODHURST DR SUITE Q-200 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-4257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366444663 | Thomas Joseph Meyer | Dentist | 1200 E Woodhurst Dr, Ste H200, Springfield, MO 65804-3776 | 2005-06-01 |
| 1770031759 | Patricia Wagner | Nurse Practitioner | 1200 E Woodhurst Dr, Q200, Springfield, MO 65804-4261 | 2016-09-19 |
| 1356700181 | Glen H Petteway, D.d.s., P.C. | Dentist | 1200 E Woodhurst Dr, Bld T, Suite 300, Springfield, MO 65804-4261 | 2016-02-22 |
| 1043691462 | Ascend Dental Design, LLC | Clinic/Center | 1200 E Woodhurst Dr, Building U, Springfield, MO 65804-4240 | 2015-06-11 |
| 1699170159 | Geosling Chiropractic Clinic, Inc | Clinic/Center | 1200 E Woodhurst Dr, Suite L200, Springfield, MO 65804-4261 | 2014-10-27 |
| 1336560010 | Thomas F, Hoff, Dds, LLC | Dentist | 1200 E Woodhurst Dr, Building F Suite 100, Springfield, MO 65807-4261 | 2013-12-23 |
| 1801234828 | Derek J Magers | Dentist | 1200 E Woodhurst Dr, Building U, Springfield, MO 65804-4261 | 2013-06-12 |
| 1073805776 | Wellness Concepts Clinic | Chiropractor | 1200 E Woodhurst Dr, Suite R300, Springfield, MO 65804-4261 | 2011-05-12 |
| 1124310107 | Candace Wawra | Hearing Instrument Specialist | 1200 E Woodhurst Dr, Suite Q Building 100, Springfield, MO 65804-4261 | 2011-05-09 |
| 1437450970 | Springfield Hearing Center | Hearing Instrument Specialist | 1200 E Woodhurst Dr, Suite Q-100, Springfield, MO 65804-4261 | 2010-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| 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 |
|---|---|---|---|---|
| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649815796 | 180 Health Lifestyle Wellness Centers | Family Medicine | 1936 S Glenstone Ave, Springfield, MO 65804-2305 | 2019-11-13 |
| 1790337988 | Aminat Ogun | Family Medicine | 520 N 4th St # 62702, Springfield, IL 62702-5238 | 2019-07-09 |
| 1770076622 | Thomas John Schumann | Family Medicine | 1260 E. Woodlawn Ave, Suite 200, Springfield, PA 19064-3988 | 2018-06-14 |
| 1134648959 | Patricia Derges | Family Medicine | 3259 E Sunshine St Ste Aa, Springfield, MO 65804-2114 | 2017-09-12 |
| 1740704667 | Mercy Management of Sepa | Family Medicine | 1001 Baltimore Pike Ste 109, Springfield, PA 19064-2852 | 2017-08-02 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1790215853 | Vincent Marchese | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2017-06-12 |
| 1184152100 | Canaan Arceneaux | Family Medicine | 1001 Baltimore Pike Ste 106, Springfield, PA 19064-2800 | 2017-06-03 |
| 1063943587 | Cody Stark Rogers | Family Medicine | 1423 N Jefferson Ave # A100, Springfield, MO 65802-1988 | 2017-03-26 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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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.