DR. HEIDI MARIE CLARK (NPI# 1255321386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255321386 |
| Entity Type | Individual |
| Full Name | DR. HEIDI MARIE CLARK |
| Credential | D.O. |
| Practice Address |
10 Trieble Dr Tunkhannock PA 18657-7054 |
| Mailing Address |
100 N Academy Ave Credentials Dept Danville PA 17822-4903 |
| Practice Telephone | 5709962700 |
| Practice Fax Number | 5709962711 |
| Mailing Telephone | 5702716144 |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2020-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS012488 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1027140510001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720154701 | Heidi Lynn Clark | Dietitian, Registered | 60 Mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535-1809 | 2006-11-28 |
| 1962821041 | Heidi Clark | Physical Therapist | 2455 Union Lake Rd, Commerce Twp, MI 48382-3596 | 2014-04-15 |
| 1649520560 | Heidi S Clark | Speech-Language Pathologist | 1000 E University Ave Dept 3311, Laramie, WY 82071-2001 | 2012-09-18 |
| 1730456427 | Heidi Clark | Acupuncturist | 4530 Sw Hall Blvd, Beaverton, OR 97005-0504 | 2011-11-23 |
| 1154614808 | Heidi C. Clark | Case Manager/Care Coordinator | 31912 Little Boston Rd Ne, Kingston, WA 98346-9700 | 2011-05-26 |
| 1487808028 | Heidi Lynn Clark | Speech-Language Pathologist | 1529 Nye Rd, Lyons, NY 14489-9111 | 2008-11-10 |
| 1992902282 | Heidi Marie Clark | Nurse Practitioner | 795 El Camino Real, Palo Alot, CA 94301-2203 | 2007-06-29 |
| 1740403542 | Heidi Ringgenberg Clark | Speech-Language Pathologist | 11688 Lake Forest Pkwy, Carmel, IN 46033-7208 | 2007-04-10 |
| 1124189196 | Heidi Clark | Nurse Practitioner | 111 Michigan Ave Nw, Washington, DC 20010-2916 | 2006-12-13 |
| Street Address |
10 TRIEBLE DR |
| City | TUNKHANNOCK |
| State | PA |
| Zip Code | 18657-7054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154883676 | Darlene Orlandini | Registered Nurse | 10 Trieble Dr, Tunkhannock, PA 18657-7054 | 2019-04-03 |
| 1659893089 | Kristyn L Croasdale | Nurse Practitioner | 10 Trieble Dr, Tunkhannock, PA 18657-7054 | 2017-07-07 |
| 1598139164 | Davis C Haire | Optometrist | 10 Trieble Dr, Suite 3, Tunkhannock, PA 18657-7054 | 2015-11-19 |
| 1588908651 | Charlea Natasha Pedro | Nurse Practitioner | 10 Trieble Dr, Tunkhannock, PA 18657-7054 | 2012-11-15 |
| 1457506099 | Renee S. Winter-bertsch | Dietitian, Registered | 10 Trieble Dr, Ste. 3, Tunkhannock, PA 18657-3816 | 2008-11-24 |
| 1205030798 | Michael M O'hara | Pharmacist | 10 Trieble Dr, Tunkhannock, PA 18657-7025 | 2007-06-11 |
| 1083752554 | Larry Dean Gehres | Psychologist | 10 Trieble Dr, Suite 3, Tunkhannock, PA 18657-7025 | 2007-02-04 |
| 1184788267 | Davis Charles Haire Sr. | Optometrist | 10 Trieble Dr, Suite #3, Tunkhannock, PA 18657-7025 | 2006-12-21 |
| 1619055035 | Geisinger Clinic | Pharmacy | 10 Trieble Dr, Tunkhannock, PA 18657-7054 | 2006-11-02 |
| 1265474530 | Kirsten A Jervis | Optometrist | 10 Trieble Dr, Suite 3, Tunkhannock, PA 18657-7054 | 2006-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194092114 | Michael Francis Lynch | Physical Therapist | 821 N Eaton Rd, Tunkhannock, PA 18657 | 2011-11-18 |
| 1013200690 | Elizabeth Lynn Shook | Pharmacist | 600 Hunter Highway, Tunkhannock, PA 18657 | 2011-05-16 |
| 1649561044 | William Zupko | Pharmacist | 420 Tioga West Plaza, Tunkhannock, PA 18657 | 2011-04-20 |
| 1659681138 | Eihab Human Services, Inc. | Psychiatric Residential Treatment Facility | 1200 State Route 92 South, Tunkhannock, NY 18657 | 2010-10-18 |
| 1780992230 | Mallory Kay Racoski | Physician Assistant | 5950 Sr 6 Fl 4, Tunkhannock, PA 18657 | 2010-09-17 |
| 1912154279 | Maya W Noble | Acupuncturist | 134 E Tioga Street, Four Winds Acupuncture Clinic, Tunkhannock, PA 18657 | 2008-08-19 |
| 1023282506 | Four Winds Acupuncture Clinic and Integrative Therapies, PC | Social Worker | 6 Sunnyside Rd, Tunkhannock, PA 18657 | 2008-04-16 |
| 1871708040 | Robin Bolinder Pinches | Physical Therapist | 880 Sr6w, Tyler Memorial Hospital, Tunkhannock, PA 18657 | 2007-05-11 |
| 1972729028 | Eugene John Geeza | Physical Therapist | Tyler Memorial Hospital, 880 Sr 6 W, Tunkhannock, PA 18657 | 2007-04-17 |
| 1104981018 | Williams Primary Care PC | Internal Medicine | 71 Hollowcrest Drive, Suite 3, Tunkhannock, PA 18657 | 2006-12-22 |
| Find all providers in zip 18657 | ||||
| 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 |
|---|---|---|---|---|
| 1073963278 | Kelsey Marie Randel | Family Medicine | 10 Trieble Dr Ste 3, Tunkhannock, PA 18657-7055 | 2016-06-18 |
| 1114999703 | Christopher D. Andres | Family Medicine | Rt. 6 Town Plaza, Tunkhannock, PA 18657 | 2006-02-07 |
| 1457345852 | Cheryle A Stone | Family Medicine | 5950 Sr 6, 4th Floor, Tunkhannock, PA 18657-7905 | 2005-08-31 |
| 1962496349 | Edward G. Zurad | Family Medicine | 71 Hollow Crest Rd, Suite 4, Tunkhannock, PA 18657-6669 | 2005-08-31 |
| 1144371998 | Cheryl A Stone Md | Family Medicine | 1 Kim Ave, Suite 10, Tunkhannock, PA 18657-9103 | 2007-01-16 |
| 1396702841 | Rodger C Sayre | Family Medicine | 10 Trieble Dr, Tunkhannock, PA 18657-7054 | 2006-04-27 |
| 1538121819 | Robert G Masci | Family Medicine | 10 Trieble Dr, Tunkhannock, PA 18657-7054 | 2006-04-04 |
| 1093783383 | Brenda T Goodrich | Family Medicine | 10 Trieble Dr, Tunkhannock, PA 18657-7054 | 2006-03-10 |
| 1972571818 | John C. Gardner | Family Medicine | 110 Trieble Rd, Tunkhannock, PA 18657 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442878 | Hallie Szymanski | Family Medicine | 3481 Frye Ave, Finleyville, PA 15332-1305 | 2020-09-19 |
| 1124633672 | Upmc Community Medicine, Inc | Family Medicine | 3140 Highland Rd Ste 102, Hermitage, PA 16148-4514 | 2020-09-11 |
| 1275147647 | Rebecca Diane Yeater | Family Medicine | Wellspan Family Medicine - Fairfield, 4910 Fairfield Rd, Fairfield, PA 17320 | 2020-09-03 |
| 1497369813 | Christina Socash | Family Medicine | 11335 Neiger Rd, Girard, PA 16417-9130 | 2020-09-02 |
| 1902410673 | Geisinger Clinic | Family Medicine | 20 Diana Ln, West Hazleton, PA 18202-1210 | 2020-09-01 |
| 1457964603 | Cynthia Rainey Raposas | Family Medicine | 3552 Woodside Rd, Hollidaysburg, PA 16648-5258 | 2020-08-27 |
| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649882275 | Blair Regenerative Medicine LLC | Family Medicine | 201 Hospital Dr Ste 2, Everett, PA 15537-7019 | 2020-08-17 |
| 1447861521 | Mature Resources Foundation | Family Medicine | 28944 Frenchville Karthaus Hwy, Frenchville, PA 16836-8834 | 2020-08-12 |
| 1619587227 | Cmp Medical LLC | Family Medicine | 3626 Sears St, Philadelphia, PA 19146-3217 | 2020-08-07 |
| Find all providers with the same taxonomy | ||||
| City | TUNKHANNOCK |
| Zip Code | 18657 |
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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.