DR. BRANDI CARROLL CLARK (NPI# 1306075502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306075502 |
| Entity Type | Individual |
| Full Name | DR. BRANDI CARROLL CLARK |
| Credential | PHARM.D. |
| Practice Address |
1081 Ga Highway 96 Warner Robins GA 31088-2507 |
| Practice Telephone | 4789877494 |
| Practice Fax Number | 4789877517 |
| Mailing Telephone | 4789877494 |
| Mailing Fax Number | 4789877517 |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2009-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH024279 | GA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124516182 | Brandi Clark | Behavior Technician | 107 Industrial Dr Ste E, Saint Marys, GA 31558-4436 | 2018-04-25 |
| 1871028274 | Brandi Nicole Clark | Pediatrics | 4900 Mueller Blvd, Suite 3s.066c, Austin, TX 78723-3079 | 2017-04-24 |
| 1154780021 | Brandi Clark | Licensed Practical Nurse | 3086 State Route 160, Gallipolis, OH 45631-8409 | 2016-02-19 |
| 1558790485 | Brandi Love Clark | Nurse Practitioner | 12502 Willowbrook Rd, Suite 300, Cumberland, MD 21502-6491 | 2013-11-01 |
| 1649614488 | Brandi L. Clark | Community/Behavioral Health | 2205 Spanish Town Ave, North Las Vegas, NV 89031-0903 | 2013-04-23 |
| 1215283569 | Brandi Clark | Home Health Aide | 605 Stanley Ave, Columbus, OH 43206-2418 | 2012-07-24 |
| 1447574389 | Brandi J Clark | Speech-Language Pathologist | 1101 Woodland Dr, Elizabethtown, KY 42701-2749 | 2010-03-22 |
| Street Address |
1081 GA HIGHWAY 96 |
| City | WARNER ROBINS |
| State | GA |
| Zip Code | 31088-2507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508053018 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1081 Ga Highway 96, Warner Robins, GA 31088-2507 | 2007-09-28 |
| 1275879991 | Matthew Earl Crist | Pharmacist | 1081 Ga Highway 96, Warner Robins, GA 31088-2507 | 2012-12-28 |
| 1306126891 | Jessica L Miranda | Pharmacist | 1081 Ga Highway 96, Warner Robins, GA 31088-2507 | 2011-08-28 |
| 1003196726 | Walgreens | Pharmacy | 1081 Ga Highway 96, Warner Robins, GA 31088-2507 | 2011-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218921 | Sarah Newman | Pharmacist | 1081 Ga-96, Warner Robins, GA 31088 | 2020-09-08 |
| 1619599115 | Alana Jane Sibley | Registered Nurse | 940 Ga - 96, Warner Robins, GA 31088 | 2020-05-07 |
| 1033779657 | Jodi Lynne Pettygrove | Nurse Practitioner | 115 Havelock Cir, Warner Robins, GA 31088 | 2019-06-17 |
| 1164994901 | Gwendolyn Jordan Taylor | Registered Nurse | 940-c Ga Hwy 96, Same, Warner Robins, GA 31088 | 2018-12-18 |
| 1447721543 | Amy Tanner | Behavioral Analyst | 200 Cresview Church Rd #1806, Warner Robins, GA 31088 | 2018-12-16 |
| 1518435676 | Phoenix Health Center | Case Management | 940 Ga-96, Warner Robins, GA 31088 | 2018-11-07 |
| 1427534320 | Jared Dean Johnson | Social Worker | 146 Lakepointe Drive, Warner Robins, GA 31088 | 2018-07-13 |
| 1285124180 | Cmp Academy & Billing Service | Contractor | 105 S Commercial Circle, Warner Robins, GA 31088 | 2018-05-16 |
| 1730692377 | Benzer Pharmacy | Pharmacy | 150 S Houston Lake Rd Ste 300, Warner Robins, GA 31088 | 2017-11-06 |
| 1821507476 | Timothy Doyle Thomas | Registered Nurse | 940-c Hwy 96, Warner Robins, GA 31088 | 2017-09-27 |
| Find all providers in zip 31088 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989547 | Allison Pierce | Pharmacist | 115 Russell Pkwy, Warner Robins, GA 31088-6175 | 2020-10-13 |
| 1982218921 | Sarah Newman | Pharmacist | 1081 Ga-96, Warner Robins, GA 31088 | 2020-09-08 |
| 1245851856 | Matthew Kennedy | Pharmacist | 4851 Russell Pkwy Ste 100, Warner Robins, GA 31088-9300 | 2020-05-05 |
| 1659806180 | David Watson | Pharmacist | 940 Ga Highway 96 Ste 200, Genoa Pharmacy, Warner Robins, GA 31088-2584 | 2017-04-21 |
| 1962949685 | Regina Carr | Pharmacist | 607 Russell Pkwy Ste D, Warner Robins, GA 31088-7641 | 2017-01-20 |
| 1437511136 | Monica Margaret Guirguis | Pharmacist | 215 Page Rd Ste 269, Warner Robins, GA 31098-1679 | 2016-03-22 |
| 1568895902 | Donald J Hancock | Pharmacist | 1331 Green Street, Warner Robins, GA 31093 | 2013-08-20 |
| 1932543972 | Jasmine J Crockett | Pharmacist | 3009 Russell Pkwy, Warner Robins, GA 31088-8657 | 2013-04-22 |
| 1790068104 | Miketu Dodia | Pharmacist | 500 Estates Way, Warner Robins, GA 31088-3144 | 2011-09-21 |
| 1952690554 | Christopher Delcourt | Pharmacist | 1331 Green St, Warner Robins, GA 31093-2749 | 2011-04-04 |
| Find all providers in WARNER ROBINS | ||||
| City | WARNER ROBINS |
| Zip Code | 31088 |
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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.