BRENDA CLARK (NPI# 1265083497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265083497 |
| Entity Type | Individual |
| Full Name | BRENDA CLARK |
| Practice Address |
5824 Catalina Dr Columbus GA 31909-4660 |
| Practice Telephone | 7065961845 |
| Mailing Telephone | 7065961845 |
| Enumeration Date | 2019-09-29 |
| Last Update Date | 2019-09-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346592946 | Brenda Flynn Clark | Social Worker | 601n State St, Ukiah, CA 95482-4026 | 2012-10-05 |
| 1346536802 | Brenda J. Clark | Massage Therapist | 19626 Nara Vista Dr, Tomball, TX 77377-3478 | 2011-06-23 |
| 1629373881 | Brenda Jill Clark | Nurse Practitioner | 2312 Ridgeway Ave, Oskaloosa, IA 52577-9109 | 2011-01-20 |
| 1710147798 | Brenda S Clark | Speech-Language Pathologist | 7501 Otoe Pl, Lincoln, NE 68506-3636 | 2008-06-12 |
| 1417979576 | Brenda B Clark | Physician Assistant | 371 Nc Hwy 65, Suite204 Rockingham Co. Dept of Public Health, Wentworth, NC 27375-0204 | 2006-07-24 |
| 1760479661 | Brenda Clark | Nurse Practitioner | 5717 Albemarle Rd, Charlotte, NC 28212-1634 | 2005-10-05 |
| 1881245850 | Brenda B Clark | Registered Nurse | 6565 Fannin St, Houston, TX 77030-2703 | 2019-09-21 |
| 1255820569 | Brenda Clark | Social Worker | 4641 Fulton Dr Nw, Canton, OH 44718-2384 | 2018-05-02 |
| 1376050914 | Brenda Belden Clark | Pharmacist | 8075 N Shadeland Ave Ste 200, Indianapolis, IN 46250-2693 | 2018-01-04 |
| 1508379504 | Brenda M Clark | Registered Nurse | 13400 E Shea Blvd, Scottsdale, AZ 85259-5452 | 2017-11-13 |
| Street Address |
5824 CATALINA DR |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31909-4660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747403 | Abundant Heart Healthcare Solution, LLC | Adult Companion | 6361 Talokas Lane, Ste C 140-279, Columbus, GA 31909 | 2020-07-14 |
| 1477185791 | Shandis Denise Phaneuf | Licensed Practical Nurse | 6545 Gregg Dr, Columbus, GA 31909 | 2020-02-05 |
| 1164086203 | Brock Musick | Physical Therapist | 100 First Court, Columbus, GA 31909 | 2019-04-24 |
| 1407340037 | Courtney Patterson | Behavior Technician | 5900 Warm Springs Road, Suite J, Columbus, GA 31909 | 2018-06-18 |
| 1225543515 | Oral & Facial Surgery of East Alabama, LLC | Dentist | 4405 N Stadium Drive, Suite A, Columbus, GA 31909 | 2017-12-08 |
| 1528577368 | Courtney Anne Young | Nurse Practitioner | 2700 Double Churches Rd, Apt 1207, Columbus, GA 31909 | 2017-09-25 |
| 1427573542 | Megan Renee Kwon | Dietitian, Registered | 4343 Warm Springs Road Apt. 110, Columbus, GA 31909 | 2017-08-09 |
| 1942659305 | Stephanie Mcghee | Dental Hygienist | 4835 Turnberry Lane, Columbus, GA 31909 | 2016-06-07 |
| 1770932162 | Tammy Allen | Dental Assistant | 701 Hoff Rd Building 9240, Ft. Benning, GA 31909 | 2016-06-07 |
| 1003265406 | Rhonda Mills | Dental Assistant | 7101 Hoff Rd Building 9240, Ft. Benning, GA 31909 | 2016-06-07 |
| Find all providers in zip 31909 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033716337 | Holly Noel Shira | Technician | 4806 Kingshill Dr, Columbus, OH 43229-6204 | 2020-10-08 |
| 1306464037 | Vickie Moore | Technician | 1639 Breeds Hill Loop, Columbus, GA 31907-7430 | 2020-07-09 |
| 1831724723 | Delvonne Mcadoo | Technician | 6075 Lepage Court, Columbus, OH 43229 | 2020-03-11 |
| 1528601234 | Raquel Moore | Technician | 849 Baycreek Ct, Columbus, GA 31907-5373 | 2019-10-25 |
| 1295386548 | Barbara Jean Thrower | Technician | 6289 Dupree Dr, Columbus, GA 31907-4485 | 2019-09-26 |
| 1619526670 | Lori Ann Pace-johnston | Technician | 741 Bedford Avenue, Columbus, OH 43205-2846 | 2019-09-11 |
| 1891343927 | Theresa Kay Alls | Technician | 7431 Bride Water Blvd, Columbus, OH 43235-4300 | 2019-09-02 |
| 1760037501 | Luisa Loke Noa I | Technician | 3527 Claretta Rd, Columbus, OH 43232-5916 | 2019-08-08 |
| 1801364013 | Sierra Jiles Johnson | Technician | 4519 Fairview Dr, Columbus, GA 31907-1219 | 2018-11-06 |
| 1215434600 | Kiven Konglim | Technician | 1415 E Dublin Granville Rd Ste 201, Columbus, OH 43229-3311 | 2018-04-11 |
| Find all providers in COLUMBUS | ||||
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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.