DR. KATHERINE A CLARK (NPI# 1366424798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366424798 |
| Entity Type | Individual |
| Full Name | DR. KATHERINE A CLARK |
| Credential | DO |
| Practice Address |
4172 Indian Ripple Rd Beavercreek OH 45440-3285 |
| Mailing Address |
8505 Crestway Rd Clayton OH 45315-8956 |
| Practice Telephone | 9374313779 |
| Practice Fax Number | 9374313776 |
| Mailing Telephone | 9374700672 |
| Mailing Fax Number | 9378365603 |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2011-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 34004845 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0935368 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992345961 | Katherine Elizabeth Clark | Licensed Practical Nurse | 764 Patriot Pkwy Apt 203, Rock Hill, SC 29730-2750 | 2020-01-08 |
| 1770146243 | Katherine T Clark | Pharmacist | 60101 Bodnar Blvd Ste 100, Mishawaka, IN 46544-9328 | 2019-04-19 |
| 1265908818 | Katherine Somers Clark | Dietitian, Registered | 2615 E 20th St, Joplin, MO 64804-1039 | 2018-10-22 |
| 1104364231 | Katherine Mary Clark | Nurse Anesthetist, Certified Registered | 9205 122nd Ct Ne, Apt A107, Kirkland, WA 98033-5882 | 2017-02-09 |
| 1528207131 | Katherine Clark | Physical Therapist | 1630 Campus Park Dr Ste D, Monroe, NC 28112-5270 | 2009-02-05 |
| 1275791949 | Katherine Diane Clark | Counselor | 400 W Midland Ave, Suite 202, Woodland Park, CO 80863-3144 | 2008-05-29 |
| 1194749978 | Katherine Elizabeth Clark | Dentist | 130 Ben Casey Dr, Suite 105, Fort Mill, SC 29708-6567 | 2006-07-26 |
| 1144289943 | Katherine W Clark | Family Medicine | 1 Paradies Ln, New Paltz, NY 12561-4031 | 2006-03-21 |
| 1548229404 | Katherine Ann Clark | Licensed Practical Nurse | 89 Laundon St, Elyria, OH 44035-6117 | 2006-03-20 |
| 1851918783 | Katherine Clark | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2020-06-26 |
| Street Address |
4172 INDIAN RIPPLE RD |
| City | BEAVERCREEK |
| State | OH |
| Zip Code | 45440-3285 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235128281 | Steven Brian Taylor | Psychiatry & Neurology | 4172 Indian Ripple Rd, Beavercreek, OH 45440-3285 | 2005-10-20 |
| 1780162172 | Tamu Swanson | Nurse Practitioner | 4172 Indian Ripple Rd, Ste A, Beavercreek, OH 45440-3286 | 2018-07-30 |
| 1659762300 | Emily Pyles | Counselor | 4172 Indian Ripple Rd, Beavercreek, OH 45440-3285 | 2015-02-16 |
| 1639501489 | Phoebe Kitsum Carpenter | Nurse Practitioner | 4172 Indian Ripple Rd, Suite A, Beavercreek, OH 45440-3285 | 2013-08-04 |
| 1548542855 | Alliance Physician Inc | Family Medicine | 4172 Indian Ripple Rd, Suite A, Beavercreek, OH 45440-3286 | 2011-09-13 |
| 1588950539 | Glenn R Armstrong | Registered Nurse | 4172 Indian Ripple Rd, Beavercreek, OH 45440-3285 | 2011-06-28 |
| 1063494714 | Gordon S Walbroehl | Family Medicine | 4172 Indian Ripple Rd, Ste. A, Beavercreek, OH 45440-3285 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427657568 | Jason Michael Knippen | Pharmacist | 5400 Cornerstone, Centerville, OH 45440 | 2020-10-20 |
| 1184222564 | Kimberly Downs | Pharmacist | 5400 North Cornerstone Blvd, Centerville, OH 45440 | 2020-10-16 |
| 1659902153 | Caryn Hoffman | Pharmacist | 5400 Cornerstone Blvd, Centerville, OH 45440 | 2020-02-03 |
| 1023673100 | Katren Elizabeth Clark | Psychologist | 70 Birch Alley, Suite 240, Dayton, OH 45440 | 2019-05-05 |
| 1649784737 | Amy Lynn Winstead | Dietitian, Registered | 5721 Bigger Road, Kettering, OH 45440 | 2017-11-28 |
| 1104245455 | Aprscp, Inc. | Hearing Instrument Specialist | 3341 East Stroop Road, Kettering, OH 45440 | 2014-04-15 |
| 1457601858 | Victoria L Saylor | Pharmacy Technician | 4480 Indianripple Rd, Dayton, OH 45440 | 2012-09-12 |
| 1528368644 | Sara Jankowski | Art Therapist | 5178 Scarsdale Dr., Kettering, OH 45440 | 2010-10-22 |
| 1356651012 | Senior Options Group | Home Health | 4025 Marshall Road, Kettering, OH 45440 | 2010-10-15 |
| 1417106345 | Sheenu Goel | Dentist | 4235 Indian Ripple Rd., Suite 200a, Dayton, OH 45440 | 2008-09-16 |
| Find all providers in zip 45440 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760019475 | Carehere LLC | Family Medicine | 3040 Kemp Rd Ste 100, Beavercreek, OH 45431-2644 | 2020-03-24 |
| 1740713254 | Kelsey Mayrand | Family Medicine | 1244 Meadow Bridge Dr Ste 100, Beavercreek, OH 45434-6388 | 2017-04-11 |
| 1760895940 | Jonathan A Clifford | Family Medicine | 2510 Commons Blvd Ste 110, Beavercreek, OH 45431-3821 | 2014-06-05 |
| 1881977171 | Alim Vivanco | Family Medicine | 2641 Hibiscus Way, Apt 312, Beavercreek, OH 45431-2393 | 2011-09-22 |
| 1639465586 | Melanie C Raffoul | Family Medicine | 1911 Old Fairfield Rd Ste 110a, Beavercreek, OH 45432-2754 | 2011-06-20 |
| 1528221157 | Green and Guirnalda Family Health Center | Family Medicine | 3359 Kemp Rd Ste 100, Beavercreek, OH 45431-2565 | 2008-07-03 |
| 1760661367 | Matthew D Moore LLC | Family Medicine | 2141 North Fairfield Road, Suite C, Beavercreek, OH 45431-2579 | 2007-10-31 |
| 1710066030 | Jane Diane Morford | Family Medicine | 1896 Shady Ln, Beavercreek, OH 45432-2063 | 2006-11-06 |
| 1316058894 | Joseph Scott Leithold | Family Medicine | 4235 Indian Ripple Road, Ste 210, Beavercreek, OH 45440 | 2006-08-31 |
| 1437198066 | Lisa Renee Vantrease | Family Medicine | 2145 N Fairfield Rd Ste 100, Beavercreek, OH 45431 | 2006-06-06 |
| Find all providers in BEAVERCREEK | ||||
| City | BEAVERCREEK |
| Zip Code | 45440 |
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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.