KIM ANN CLARK (NPI# 1316135312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316135312 |
| Entity Type | Individual |
| Full Name | KIM ANN CLARK |
| Practice Address |
829 Halbert St Malvern AR 72104-2607 |
| Practice Telephone | 5013324400 |
| Mailing Telephone | 5013324400 |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760638290 | Kim Michele Clark | Registered Nurse | 6820 Nw Grandview Dr, Corvallis, OR 97330-2706 | 2008-08-15 |
| 1700934072 | Kim M. Clark | Massage Therapist | 9508 Canyon Rd E, Puyallup, WA 98371-6302 | 2007-01-05 |
| 1215091095 | Kim M Clark | Optometrist | 12000 Se 82nd Avenue, #2012, Portland, OR 97266-7721 | 2006-12-19 |
| 1497236301 | Kim Clark | Counselor | 1800 Mercy Dr, Orlando, FL 32808-5646 | 2018-08-28 |
| 1225428402 | Kim Clark | Behavioral Analyst | 510 W. 11th Street, Family Solutions, Medford, OR 97501 | 2015-01-27 |
| 1023255940 | Kim Evans Clark | Nurse Anesthetist, Certified Registered | 701 Grove Rd, 2nd Floor Anesthesia, Greenville, SC 29605-5611 | 2009-01-14 |
| 1609069087 | Kim J. Clark | Massage Therapist | 1424 16th Ave, Longview, WA 98632-2901 | 2007-08-20 |
| 1508074311 | Kim Clark | Social Worker | 226 Leonard Rd, South Royalton, VT 05068-9565 | 2007-05-18 |
| Street Address |
829 HALBERT ST |
| City | MALVERN |
| State | AR |
| Zip Code | 72104-2607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639180805 | Tfs of Gurdon Inc | Clinic/Center | 829 Halbert St, Malvern, AR 72104-2607 | 2006-08-11 |
| 1245842343 | Kelcey Crutchfield | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2020-08-19 |
| 1477186518 | Joe Bryant | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2020-02-18 |
| 1003449356 | Dayla Rogers | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2020-02-14 |
| 1033740808 | Karen Eason | Counselor | 829 Halbert St, Malvern, AR 72104-2607 | 2020-01-30 |
| 1922649532 | Courtney Bacon-latina | Counselor | 829 Halbert St, Malvern, AR 72104-2607 | 2019-10-04 |
| 1689231904 | Jennifer Edwards | Counselor | 829 Halbert St, Malvern, AR 72104-2607 | 2019-05-22 |
| 1689144172 | Quinton Revels | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2018-11-28 |
| 1689143133 | Paramount Behavioral Health Inc | Community/Behavioral Health | 829 Halbert St, Malvern, AR 72104-2607 | 2018-11-14 |
| 1528536729 | Jeff Parker | Social Worker | 829 Halbert St, Malvern, AR 72104-2607 | 2018-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659907707 | Terrence Randell Mitchell | Prosthetist | 991 Mount Willow Rd., Malvern, AR 72104 | 2020-03-20 |
| 1356837959 | American Oncology Partners, P.a. | Internal Medicine | 1001 Schneider Dr Ste 105, Malvern, AR 72104 | 2018-07-06 |
| 1114262839 | Charloda Nolen | Case Manager/Care Coordinator | 1710 E Page, Malvern, AR 72104 | 2012-12-06 |
| 1427349257 | Malvern Physical Therapy and Wellness | Physical Therapist | 1601 Hwy 270 W, Suite 104, Malvern, AR 72104 | 2011-04-27 |
| 1194037069 | Alternative Opportunities | Community/Behavioral Health | 1519 East Page Avenue, Malvern, AR 72104 | 2010-07-08 |
| 1285878991 | Pro-active Rehab Inc. | Physical Therapist | 720 Walco Rd, Suite 240, Malvern, AR 72104 | 2009-04-24 |
| 1932380599 | Vallerie Ahart | Licensed Practical Nurse | 1022 East Page, Malvern, AR 72104 | 2007-11-23 |
| 1104013598 | Vivian Brown | Home Health Aide | 913 Magnolia, Malvern, AR 72104 | 2007-09-28 |
| 1467665919 | Annette Jean Bowersox | Registered Nurse | 1399 Jenny Road, Malvern, AK 72104 | 2007-05-08 |
| 1730305798 | Jacqueline Kilgore LLC | Skilled Nursing Facility | 912 Section Line St, Malvern, AR 72104 | 2007-04-18 |
| Find all providers in zip 72104 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114262839 | Charloda Nolen | Case Manager/Care Coordinator | 1710 E Page, Malvern, AR 72104 | 2012-12-06 |
| 1588876197 | Eric Hines | Case Manager/Care Coordinator | 1708 E Page Ave, Malvern, AR 72104-4540 | 2007-05-04 |
| 1700951068 | Brandi Bristow | Case Manager/Care Coordinator | 1615 Martin Luther King Blvd., Malvern, AR 72104 | 2006-11-22 |
| 1497353502 | Heath Roseberry | Case Manager/Care Coordinator | 1628 E Page Ave, Malvern, AR 72104-4524 | 2020-10-12 |
| 1245842343 | Kelcey Crutchfield | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2020-08-19 |
| 1295346757 | Bonnie Lynn Mann | Case Manager/Care Coordinator | 1615 Martin Luther King Blvd, Malvern, AR 72104-2233 | 2020-08-10 |
| 1538787890 | Caleb Mckissick | Case Manager/Care Coordinator | 1628 E Page Ave, Malvern, AR 72104-4524 | 2020-07-13 |
| 1356977037 | Malik Ware | Case Manager/Care Coordinator | 1628 E Page Ave, Malvern, AR 72104-4524 | 2020-03-13 |
| 1558997213 | Akena Holliman | Case Manager/Care Coordinator | 1628 E Page Ave, Malvern, AR 72104-4524 | 2020-03-13 |
| 1477186518 | Joe Bryant | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2020-02-18 |
| Find all providers in MALVERN | ||||
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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.