AMANDA M CLARK (NPI# 1255808085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255808085 |
| Entity Type | Individual |
| Full Name | AMANDA M CLARK |
| Practice Address |
2301 Timberline Ct Apt F105 Ruston LA 71270 |
| Mailing Address |
2301 Timberline Ct Apt F105 Ruston LA 71270-5292 |
| Practice Telephone | 2108273950 |
| Mailing Telephone | 2108273950 |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2019-11-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 1255808085 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 309 Circle Dr, Corpus Christi, TX 784122529 | 2108273950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851680 | Amanda Lou Clark | Technician | 4631 Diana Dr, Diana, WV 26217-8777 | 2020-08-11 |
| 1225666035 | Amanda Louise Clark | Registered Nurse | 10 Mcclennan Banks Dr, Charleston, SC 29425-0001 | 2020-03-28 |
| 1881220226 | Amanda S Clark | Nurse Practitioner | 1115 State St # 4342, Cayce, SC 29033-4342 | 2020-03-17 |
| 1467956003 | Amanda K Clark | Respiratory Therapist, Certified | 1225 Laurel St Ste 219, Columbia, SC 29201-5826 | 2018-03-20 |
| 1992257281 | Amanda Clark | Occupational Therapy Assistant | 7146 Bahne Rd, Fairview, TN 37062 | 2016-11-02 |
| 1578938163 | Amanda Leigh Clark | Occupational Therapy Assistant | 218 Mill Hill Acres Dr, Peterstown, WV 24963-9797 | 2015-12-08 |
| 1043554256 | Amanda J Clark | Physical Therapist | 1312 W Arch Haven Ave Bldg 1320, Suite E, Bloomington, IN 47403-2089 | 2012-11-15 |
| 1770810954 | Amanda J Clark | Specialist/Technologist | 8700 Sheridan Road, Nw, Thornville, OH 43076 | 2009-11-10 |
| 1891967204 | Amanda Bleu Clark | Counselor | 150 Nickerson St Ste 303, Seattle, WA 98109 | 2008-03-25 |
| 1689682205 | Amanda Lou Clark | Obstetrics & Gynecology | 5050 Ne Hoyt St Ste 255, Portland, OR 97213-2982 | 2006-08-03 |
| Street Address |
2301 TIMBERLINE CT APT F105 |
| City | RUSTON |
| State | LA |
| Zip Code | 71270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821315 | Olivia Mason | Marriage & Family Therapist | 413 North Homer Street, Ruston, LA 71270 | 2020-11-04 |
| 1972146132 | Razz Addiction and Recovery, LLC | Family Medicine | 570 Heard Rd, Ruston, LA 71270 | 2019-10-21 |
| 1518435999 | Tenia Holloway | Case Manager/Care Coordinator | 612 Henderson St., F12, Ruston, LA 71270 | 2018-11-05 |
| 1245708718 | A Plus Medical of Ruston LLC | Family Medicine | 612 S Farmerville Street, Ruston, LA 71270 | 2018-11-02 |
| 1912473752 | Lincoln Nova Vital Recovery | Counselor | 4396 Hwy, 80, 617 South Trention, Ruston, LA 71270 | 2018-10-19 |
| 1861975237 | Wymeka Andrea Breaux | Case Manager/Care Coordinator | 705 Martin Luther King Dr., Ruston, LA 71270 | 2018-09-12 |
| 1790292001 | Louquyhanta Foster | Case Manager/Care Coordinator | 593 Belton Rd, Ruston, LA 71270 | 2018-01-08 |
| 1609391010 | Chemia Herron | Counselor | 775 S Bonner, Ruston, LA 71270 | 2017-08-07 |
| 1477083517 | Arnesha Beard | Counselor | 775 South Bonner, Ruston, LA 71270 | 2017-06-12 |
| 1881123289 | Shayla Jackson | Counselor | 775 South Bonner Street, Ruston, LA 71270 | 2017-06-08 |
| Find all providers in zip 71270 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174052443 | Byron Pottorff | Specialist/Technologist | 1450 West Alabama, Ruston, LA 71272 | 2017-06-08 |
| 1043749336 | Adrianne Marie Bosworth | Specialist/Technologist | 1450 West Alabama Avenue, Ruston, LA 71272 | 2017-06-08 |
| 1508226002 | Christopher Watson | Specialist/Technologist | 1408 Tech Farm Rd, Apt C-6, Ruston, LA 71270-5462 | 2016-02-26 |
| 1548625130 | William Word | Specialist/Technologist | 306 W. Louisiana Ave. #8, Ruston, LA 71270 | 2015-12-23 |
| 1063887610 | Taylor Nugent I | Specialist/Technologist | 217 Penny Ln, Ruston, LA 71270-4166 | 2015-12-08 |
| 1760855688 | Justin Wheeler | Specialist/Technologist | 1450 W Alabama Ave, Ruston, LA 71272-2711 | 2015-11-02 |
| 1588036651 | Roberto Cardona | Specialist/Technologist | 1450 W. Alabama, Ruston, LA 71272 | 2015-10-28 |
| 1780056069 | Jill Hancock | Specialist/Technologist | 1450 W Alabama, Ruston, LA 71272-0001 | 2015-10-26 |
| 1316474331 | Kayla Wincko | Specialist/Technologist | 305 Wisteria St, Ruston, LA 71272-0001 | 2017-05-22 |
| 1124574702 | Brittany Luttrell | Specialist/Technologist | 1450 W Alabama Ave, Ruston, LA 71270 | 2016-09-01 |
| Find all providers in RUSTON | ||||
Please comment or provide details below to improve the information on AMANDA M CLARK.
| 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.