MS. SHANNON L CLARK (NPI# 1316240401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316240401 |
| Entity Type | Individual |
| Full Name | MS. SHANNON L CLARK |
| Credential | LMT |
| Practice Address |
1117 Rio Rancho Dr Se Ste 6g Rio Rancho NM 87124-1859 |
| Practice Telephone | 5058911414 |
| Practice Fax Number | 5058911444 |
| Mailing Telephone | 5058911414 |
| Mailing Fax Number | 5058911444 |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2010-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 6379 | NM | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366931552 | Shannon Clark | Registered Nurse | 8201 S 61st St, Lincoln, NE 68516-5994 | 2018-05-03 |
| 1457786675 | Shannon Clark | Occupational Therapy Assistant | 860 W 132nd Ave, Spc 268, Westminster, CO 80234-1499 | 2013-09-06 |
| 1881726271 | Shannon Denise Clark | Nurse Practitioner | 2 Easton Oval Ste 450, Columbus, OH 43219-6035 | 2007-03-12 |
| 1760537617 | Shannon Renee Clark | Nurse Practitioner | 3128 Santa Rita Rd, Suite C, Pleasanton, CA 94566-8300 | 2007-01-23 |
| 1700940855 | Shannon Jackie Clark | Contractor | 10750 S Knoll Crest Ln, Tucson, AZ 85706-9052 | 2006-12-21 |
| 1720089311 | Shannon Lynn Clark | Chiropractor | 423 Main St, Reinbeck, IA 50669-1049 | 2005-08-03 |
| 1487149373 | Shannon Clark | Counselor | 90 Hospital Dr, Athens, OH 45701-2301 | 2018-06-25 |
| 1679021448 | Shannon Lorraine Clark | Speech-Language Pathologist | 2251 E Paris Ave Se, Grand Rapids, MI 49546-2431 | 2016-09-21 |
| 1508299777 | Shannon Joan Clark | Nurse Practitioner | 3604 Bush St, Raleigh, NC 27609-7511 | 2013-08-12 |
| 1770916033 | Shannon M Clark | Specialist/Technologist, Other | 3 Maryland Farms Ste 200, Brentwood, TN 37027-5780 | 2013-08-09 |
| Street Address |
1117 RIO RANCHO DR SE STE 6G |
| City | RIO RANCHO |
| State | NM |
| Zip Code | 87124-1859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154624591 | Sarah E Komala | Massage Therapist | 1117 Rio Rancho Dr Se Ste 6g, Rio Rancho, NM 87124-1859 | 2010-12-07 |
| 1447553789 | Andrea Twitchell | Massage Therapist | 1117 Rio Rancho Dr Se Ste 6g, Rio Rancho, NM 87124-1859 | 2010-12-08 |
| 1558664847 | Laura Smith | Massage Therapist | 1117 Rio Rancho Dr Se Ste 6g, Rio Rancho, NM 87124-1859 | 2010-12-08 |
| 1114220480 | David Bowes | Massage Therapist | 1117 Rio Rancho Dr Se Ste 6g, Rio Rancho, NM 87124-1859 | 2010-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895648 | Dallon Knight | Pharmacist | 1115 Nm-528 Se, Rio Rancho, NM 87124 | 2020-09-09 |
| 1447875133 | Paul D Phillip | Counselor | 1207 Golf Course Rd Ne, Suite C, Rio Rancho, NM 87124 | 2020-06-09 |
| 1093341810 | Clearsky Rehabilitation Hospital of Rio Rancho LLC | Rehabilitation Hospital | 2401 Westside Blvd, Rio Rancho, NM 87124 | 2020-03-13 |
| 1841840345 | Debra English | Technician | 2001 Yucca St Se, Rio Rancho, NM 87124 | 2019-09-17 |
| 1114589322 | Counseling Connections, LLC | Counselor | 2600 Istle Rd Ne, Rio Rancho, NM 87124 | 2019-07-08 |
| 1417414996 | Kimberly Lovette Lorenzini | Counselor | Rio Rancho Family Counseling, 1340 Monterrey Rd, Rio Rancho, NM 87124 | 2019-02-21 |
| 1225507197 | Speech and Language Possibilities, LLC | Audiologist | 273 Tigris Road Ne, Rio Rancho, NM 87124 | 2018-11-20 |
| 1063997823 | Cindy Pendrey, LLC | Clinic/Center | 2103 Golf Course Rd Se, Suite A, Rio Rancho, NM 87124 | 2018-09-27 |
| 1972094324 | Calmar Inc. | Durable Medical Equipment & Medical Supplies | 2003 Southern Blvd Ne, Suite 123, Rio Rancho, NM 87124 | 2018-05-22 |
| 1013404581 | New Mexico Dental Clinics LLC | Dentist | 1594 Sara Rd Se Ste C, Rio Rancho, NM 87124 | 2018-04-19 |
| Find all providers in zip 87124 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710510458 | Ellen Annette Santistevan-salazar | Massage Therapist | 1410 Sunset Rd Se, Rio Rancho, NM 87124-2629 | 2020-02-21 |
| 1780223149 | Jaclynn Arden | Massage Therapist | 4011 Barbara Loop Se Ste 104a, Rio Rancho, NM 87124-1040 | 2020-01-03 |
| 1972163970 | Adam Cotton | Massage Therapist | 2440 Violeta Cir Se, Rio Rancho, NM 87124-2595 | 2019-06-20 |
| 1295263416 | Tamara Denise Hill | Massage Therapist | 1710 Agua Dulce Dr Se, Rio Rancho, NM 87124-8746 | 2017-06-01 |
| 1821429341 | Hollee Hamamoto | Massage Therapist | 6520 Quail Run Rd Ne, Rio Rancho, NM 87144-5190 | 2013-12-09 |
| 1326473638 | Lisa Nicole Melendez | Massage Therapist | 3610 Havasu Falls St Ne, Rio Rancho, NM 87144 | 2013-09-05 |
| 1528317633 | Laura Jeanne Silva | Massage Therapist | 101 Aster Dr Sw, Rio Rancho, NM 87124 | 2012-09-05 |
| 1588948475 | Milonie Rose Lilly | Massage Therapist | 3803 Cattle Dr Ne, Rio Rancho, NM 87144-6389 | 2011-10-10 |
| 1124321450 | Komala Therapeutic Massage | Massage Therapist | 1117 Rio Rancho Blvd Suite 6g, Rio Rancho, NM 87124 | 2010-12-08 |
| 1154624591 | Sarah E Komala | Massage Therapist | 1117 Rio Rancho Dr Se Ste 6g, Rio Rancho, NM 87124-1859 | 2010-12-07 |
| Find all providers in RIO RANCHO | ||||
| City | RIO RANCHO |
| Zip Code | 87124 |
Please comment or provide details below to improve the information on MS. SHANNON L 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.