MR. MATTHEW WILLIAM CLARK (NPI# 1245284629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245284629 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW WILLIAM CLARK |
| Credential | IDC |
| Practice Address |
Uss Philippine Sea Fpo AA 34092-1178 |
| Mailing Address |
453 Cody Dr Orange Park FL 32073-4214 |
| Practice Telephone | 9042706502 |
| Mailing Telephone | 9042705936 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2010-05-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033578653 | Matthew Mitchell Clark | Student in an Organized Health Care Education/Training Program | 2644 Crystal Falls Rd, Lexington, KY 40509-4208 | 2016-02-11 |
| 1154787844 | Matthew Clark | Chiropractor | 5250 S Commerce Dr Ste 155, Murray, UT 84107-5379 | 2016-01-11 |
| 1811001126 | Matthew David Ayers Clark | Psychologist | 7150 Kalamazoo Ave Se, Ste C, Caledonia, MI 49316-9126 | 2006-08-17 |
| 1215993308 | Matthew Alexander Clark | Internal Medicine | Ute Mountain Ute Health Center, Complex B Rustling Willow Street, Towaoc, CO 81334-0049 | 2006-04-26 |
| 1407341134 | Matthew Howard Clark | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905 | 2018-06-25 |
| 1639674591 | Matthew Anthony Clark | Student in an Organized Health Care Education/Training Program | 22 Bramhall St, Portland, ME 04102-3134 | 2018-03-24 |
| 1588104913 | Matthew Louis Clark | Pharmacist | 4747 Sawmill Rd, Columbus, OH 43220-2490 | 2017-03-04 |
| 1679949184 | Matthew Clark | Optometrist | 2792 E 146th St, Carmel, IN 46033-7718 | 2015-08-19 |
| 1902288806 | Matthew Lewis Clark | Dermatology | 8245 Holly Rd Ste 101, Grand Blanc, MI 48439-2443 | 2015-06-26 |
| 1417353996 | Matthew Clark | Counselor | 360 Bloomfield Ave, Ste 301, Windsor, CT 06095-2700 | 2014-11-12 |
| Street Address |
USS PHILIPPINE SEA |
| City | FPO |
| State | AA |
| Zip Code | 34092-1178 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891763777 | Christopher Bernard Barber | Military Health Care Provider | Uss Philippine Sea, Fpo, AA 34092-1178 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336350354 | Patrick Deon Hawkins | Military Health Care Provider | Uss Rhode Island (ssbn 740) Gold, Fpo, AA 34092 | 2007-05-24 |
| 1578531992 | L.v. Hall Jr. | Military Health Care Provider | Uss Samuel B. Roberts (ffg 58), Fpo Aa, Mayport, FL 34092-1512 | 2006-03-10 |
| 1083670194 | David Mitchell Edwards | Military Health Care Provider | Uss Maryland Ssbn 738 Blue, Fpo, AA 34092-2129 | 2006-04-26 |
| 1952631228 | Shawn Anthony Fisher | Military Health Care Provider | Uss Rhode Island (ssbn 740), Fpo, AA 34092-2136 | 2010-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899853 | London Mingo | Social Worker | 2769 Yaka Kin Cho, Fpo, AP 96388-0071 | 2020-10-21 |
| 1538768833 | James Blake Weldon | Military Health Care Provider | Unit 100517 Bx 1, Fpo, AP 09655 | 2020-10-19 |
| 1487260311 | Doria Living | Registered Nurse | Ushno, Fpo, AP 96367 | 2020-09-16 |
| 1225643307 | Brice Blahnik | Dentist | 1 St Dental Battalion/naval Dental Center Attn: Medical, Bldg 2238 A Ave Camp Pendleton, Ca. 92055-5221, Fpo, AA 92055-5221 | 2020-09-15 |
| 1609489061 | Genesis Health Care Inc | Home Health | Uss Wasp Lhd1 Unit 100261, Fpo, AE 09514 | 2020-08-26 |
| 1669081857 | Acacia L Elmer | Registered Nurse | Psc 808 Box 3104, Fpo, AE 09618-0032 | 2020-07-24 |
| 1932724754 | William Dowling | Student in an Organized Health Care Education/Training Program | 260 John Paul Jones Circle, Fpo, AA 23708 | 2020-06-09 |
| 1518581776 | Taylor D Benson | Audiologist | Building 960, Floor 3, East Wing, Fpo, AP 96362-0017 | 2020-06-03 |
| 1740803279 | Issa Khalil | Military Health Care Provider | Uss Donald Cook, Fpo, AE 09566 | 2020-05-19 |
| 1295360055 | Kiran Kumar Gurung | Dental Hygienist | Uss Bataan (lhd-5), Fpo, AE 09554-1657 | 2020-03-11 |
| Find all providers in FPO | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538768833 | James Blake Weldon | Military Health Care Provider | Unit 100517 Bx 1, Fpo, AP 09655 | 2020-10-19 |
| 1740803279 | Issa Khalil | Military Health Care Provider | Uss Donald Cook, Fpo, AE 09566 | 2020-05-19 |
| 1396370623 | Daniel Rocha Moy | Military Health Care Provider | Uss Thunderbolt (pc-12), Fpo, AE 09588 | 2020-03-06 |
| 1639701634 | Stephen Henderson | Military Health Care Provider | 3d Recon Bn, Force Co., Unit 36180, Fpo, AP 96389-6180 | 2020-02-07 |
| 1649810219 | Maxwell Onyedikachi Osisioma | Military Health Care Provider | Psd-18, Macg-18, 1st Maw Unit 37172, Fpo, AP 96372 | 2020-01-13 |
| 1508406273 | Daniel Levin | Military Health Care Provider | 3d Recon Bn Aid Station, Fpo, AP 96389-6189 | 2020-01-10 |
| 1053955609 | Christopher Zartman | Military Health Care Provider | Camp Foster, Okinawa Japan, Fpo, AP 96379-0005 | 2019-11-06 |
| 1912553975 | Brandon Joseph Dapper | Military Health Care Provider | Camp Lejeune, Nc, 2d Reconnaissance Battalion Battalion Aid Station, Fpo, AA 28542-0138 | 2019-08-15 |
| 1518525583 | William Edward Mcbreen Jr. | Military Health Care Provider | Coastal Riverine Group 1 Detachment Guam, Fpo, AP 96540-1400 | 2019-06-04 |
| 1558832345 | Nathaniel Franklin Campbell | Military Health Care Provider | Rr 612 Everett Creek Rd, Camp Lejuene, Fpo, AE 28542 | 2018-12-06 |
| Find all providers in FPO | ||||
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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.