ADRIENNE L CLARK


Address: 5154 Ellsworth Ave, Suite 61690, Las Vegas, NV 89191
Phone: 7026523507

ADRIENNE L CLARK (NPI# 1225263072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225263072
Entity Type Individual
Full Name ADRIENNE L CLARK
Credential IDMT
Practice Address 5154 Ellsworth Ave
Suite 61690
Las Vegas
NV 89191
Mailing Address 5154 Ellsworth Ave
Bldg 61690
Las Vegas
NV 89191
Practice Telephone 7026523507
Mailing Telephone 7026523507
Enumeration Date 2009-05-22
Last Update Date 2009-05-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Other Providers ADRIENNE CLARK

NPI Name Taxonomy Address Enumeration
1972129195 Adrienne Jenkins Clark Nurse Practitioner 10053 Florida Blvd Unit 627, Walker, LA 70785-5097 2020-06-23
1245667724 Adrienne Clark Counselor 6615 Quincy St, Philadelphia, PA 19119-2719 2013-09-30
1023628955 Adrienne Clark Dietitian, Registered 1200 Westwood Dr, Hamilton, MT 59840-2345 2020-08-05
1821364142 Adrienne L Clark Internal Medicine 2505 2nd Ave Ste 200, Seattle, WA 98121-1495 2012-03-30
1386913879 Adrienne Renee Clark Specialist/Technologist 2312 S Dixon Rd, Suite 250, Kokomo, IN 46902-6401 2011-12-29
1538450820 Adrienne Nicole Clark Psychiatry & Neurology 3400 Spruce St, Philadelphia, PA 19104-4206 2011-04-21

Office Location

Street Address 5154 ELLSWORTH AVE
SUITE 61690
City LAS VEGAS
State NV
Zip Code 89191

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225662687 Ashley Raye Roth-garcia Student in an Organized Health Care Education/Training Program 99th Medical Group 4700 Las Vegas Blvd North, Nellis Afb, NV 89191 2020-02-25
1427553734 Christopher Robert Weisgarber Student in an Organized Health Care Education/Training Program Mike O'callaghan Military Medical Center, 4700 Las Vegas Blvd North Bldg 1300, Las Vegas, NV 89191 2018-03-28
1912345448 Austin Joseph Ladner Dentist 99th Air Base Wing Public Affairs, Fpo, AA 89191 2013-06-06
1528329018 Mayer M Jeppson Psychologist 4700 Las Vegas Blvd. N, Nellis Afb, NV 89191 2012-05-31
1255560462 Jordan Lawrence Military Health Care Provider 1579 Malmstrom Avenue, Nellis Afb, NV 89191 2009-07-09
1568634335 Eleanor C Basilio Registered Nurse 4700 Las Vegas Blvd., Nellis Afb, NV 89191 2008-04-01
1316137037 Sarah Rachel Glick Pediatrics 4700 N. Las Vegas Blvd., Mike O'callaghan Federal Medical Center, 99 Mdos/sgoc, Nellis Afb, NV 89191 2007-07-30
1619181302 Ben Carter Robinson Orthopaedic Surgery 4700 N. Las Vegas Blvd, Nellis Afb-mofh Nellis Orthopedics, Las Vegas, NV 89191 2007-05-10
1609992205 Conrad Lochner IIi, Odpc Optometrist 5691 Rickenbacker Road, Bldg. 431, Las Vegas, NV 89191 2007-03-22
1730228321 Dana Windhorst Preventive Medicine 4700 Las Vegas Blvd N., Nellis Afb, NV 89191 2007-02-06
Find all providers in zip 89191

Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Notes: Source: Air Force Surgeon General Office [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033607478 Steven Correa Military Health Care Provider 4700 Las Vegas Blvd N # 1300, Las Vegas, NV 89191-6600 2018-05-01
1518483320 Jessica Ann Ewers Military Health Care Provider 8701 W Gilmore Ave, Las Vegas, NV 89129-7687 2017-08-15
1306175096 Ta'wana L Jones Military Health Care Provider 1900 Las Vegas Blvd, Las Vegas, NV 89110 2009-12-09
1346483500 Brandy R Williams Military Health Care Provider 9303 Gilcrease Ave, Unit 1207, Las Vegas, NV 89149-0199 2009-04-16
1528604758 Nicholas Brown Dyches Military Health Care Provider 4700 Las Vegas Blvd N Bldg 1300, Las Vegas, NV 89191-6600 2019-11-22
1235637000 Jeffrey Allen Villalpando Military Health Care Provider 4700 Las Vegas Blvd N, Las Vegas, NV 89191-6600 2018-01-26
1598190878 Jonathan Christian Gomez Military Health Care Provider 4311 Carswell Ave, Bldg 340, Las Vegas, NV 89191-7069 2013-09-05
1043554462 Ryan Mosiah King Military Health Care Provider 4700 Las Vegas Blvd N, Las Vegas, NV 89191-6600 2012-11-26
1588914295 Jill S Dowd Military Health Care Provider 4700 North Las Vegas Blvd, Las Vegas, NV 89115 2012-09-11
1518197078 Tanya Lane Hatfield Military Health Care Provider 811 Grier Dr, Suite B, Las Vegas, NV 89119-3704 2009-07-19
Find all providers in LAS VEGAS

Competitor

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City LAS VEGAS
Zip Code 89191

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Dataset Information

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.

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