JACQUELINE CLARK (NPI# 1336552629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336552629 |
| Entity Type | Individual |
| Full Name | JACQUELINE CLARK |
| Credential | ATC, CSCS |
| Practice Address |
550 Huntington Ave Boston MA 02115-5901 |
| Mailing Address |
47 Paragon Rd Unit 2 West Roxbury MA 02132-5127 |
| Practice Telephone | 6179894144 |
| Practice Fax Number | 6179894150 |
| Mailing Telephone | 6177592912 |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1867 | MA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720594955 | Jacqueline Clark | Behavior Technician | 10530 Warwick Ave Ste C2, Fairfax, VA 22030-3132 | 2017-12-26 |
| 1497015762 | Jacqueline Clark | Counselor | 923 Powell Ave Sw, Suite 100, Renton, WA 98057-2941 | 2012-05-21 |
| 1407008287 | Jacqueline Ruth Clark | Licensed Practical Nurse | 26308 Crocker Rd, Columbia Station, OH 44028-9301 | 2008-10-13 |
| 1902424161 | Jacqueline E Clark | Advanced Practice Midwife | 1021 Nebraska St, Sioux City, IA 51105-1436 | 2020-07-13 |
| 1205456795 | Jacqueline Clark | Behavior Technician | 182 El Dorado St, Monterey, CA 93940-3118 | 2020-04-24 |
| 1982175493 | Jacqueline Clark | Occupational Therapist | 888 Terrace St, Muskegon, MI 49440-1220 | 2018-12-10 |
| 1194244749 | Jacqueline Ann Clark | Counselor | 811 Madison St, Everett, WA 98203-4543 | 2017-09-14 |
| 1215452958 | Jacqueline Clark | Physical Therapist | 546 E Sandy Lake Rd Ste 110, Coppell, TX 75019-5787 | 2017-08-03 |
| 1245578343 | Jacqueline Anne Clark | Counselor | 2845 Bell St, Zanesville, OH 43701-1720 | 2013-01-24 |
| 1013255611 | Jacqueline Marie Clark | Registered Nurse | 700 19th St S, Birmingham, AL 35233-1927 | 2013-01-17 |
| Street Address |
550 HUNTINGTON AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-5901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427514348 | Maura Mulligan | Social Worker | 550 Huntington Ave, Boston, MA 02115-5901 | 2019-02-15 |
| 1093194839 | Sara Casey Cline | Specialist/Technologist | 550 Huntington Ave, Boston, MA 02115-5901 | 2015-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| 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 |
|---|---|---|---|---|
| 1700486693 | Mark Comstock | Specialist/Technologist | 74 Union Park St, Boston, MA 02118-2142 | 2020-10-29 |
| 1194289892 | Jacob White | Specialist/Technologist | 580 Commonwealth Ave Unit 501, Boston, MA 02215-2509 | 2019-01-27 |
| 1508333642 | Varshini Balasubramanian | Specialist/Technologist | 580 Commonwealth Ave Unit 307, Boston, MA 02215-2511 | 2018-10-26 |
| 1770081143 | Brittney Ann Harkey | Specialist/Technologist | 60 Fenwood Rd Ste 5016, Boston, MA 02115-6128 | 2018-01-31 |
| 1942708169 | Matthew Stephen Harkey | Specialist/Technologist | 35 Kneeland Street, 4th Floor, Boston, MA 02115-0211 | 2018-01-23 |
| 1740798065 | Hannah Oyedeji | Specialist/Technologist | 627 Commonwealth Ave, Boston, MA 02215-1606 | 2018-01-22 |
| 1205364247 | Emma Marie Gay | Specialist/Technologist | 285 Babcock Street, Case Center Athletic Training Clinic, Boston, MA 02215-1003 | 2017-06-02 |
| 1962959825 | Anna Jeanne Applegate | Specialist/Technologist | 140 Bay State Rd, Box 5361, Boston, MA 02215-1701 | 2016-09-07 |
| 1023475076 | Calleigh Fangmeyer | Specialist/Technologist | 65 North Harvard Street, Boston, MA 02163 | 2016-01-21 |
| 1053700955 | Cynthia Lopez | Specialist/Technologist | 254 Allston St # B, Boston, MA 02135-7660 | 2015-01-15 |
| Find all providers in BOSTON | ||||
Please comment or provide details below to improve the information on JACQUELINE 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.