CLARK CLINIC INC (NPI# 1376733857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376733857 |
| Entity Type | Organization |
| Organization Name | CLARK CLINIC INC |
| Practice Address |
212 S Florida St Bushnell FL 33513-6703 |
| Practice Telephone | 3527932441 |
| Practice Fax Number | 3527932649 |
| Mailing Telephone | 3527932441 |
| Mailing Fax Number | 3527932649 |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2007-12-27 |
| Authorized Official Name | ELIZABETH E FOLK (PRESIDENT) |
| Authorized Official Telephone | 3527932441 |
| Authorized Official Credential | ED.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
FL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013540947 | Clark Clinic Inc | Clinic/Center | 12620 Curley St, San Antonio, FL 33576-8136 | 2020-02-19 |
| 1639693492 | Clark Clinic Inc | Clinic/Center | 910 W Myers Blvd, Mascotte, FL 34753-9748 | 2017-08-02 |
| 1467642942 | Clark Clinic Inc | Clinic/Center | 107 W Central Ave, Howey In The Hills, FL 34737-4302 | 2007-07-31 |
| 1992338156 | Clark Clinic Inc | Clinic/Center | 110 Lodge Terrace Dr, Altoona, FL 32702-9668 | 2020-02-17 |
| 1225661481 | Clark Clinic Inc | Clinic/Center | 31450 Church St, Sorrento, FL 32776-9594 | 2020-02-17 |
| Street Address |
212 S FLORIDA ST |
| City | BUSHNELL |
| State | FL |
| Zip Code | 33513-6703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467441790 | Vijaya L Nagabhairu | Family Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2005-10-19 |
| 1154893477 | Noelle Mooneyham | Nurse Practitioner | 212 S Florida St, Bushnell, FL 33513-6703 | 2018-12-27 |
| 1154804615 | Mary Hyacinth Bodenheimer | Nurse Practitioner | 212 S Florida St, Bushnell, FL 33513-6703 | 2018-09-11 |
| 1669897377 | Ronnie-jane Boekema | Registered Nurse | 212 S Florida St, Bushnell, FL 33513-6703 | 2014-03-04 |
| 1942648803 | Akram Youssef | Family Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2013-06-12 |
| 1740531011 | Daniel D Dstteffano | General Practice | 212 S Florida St, Clark Clinic Inc, Bushnell, FL 33513-6703 | 2012-09-27 |
| 1306108022 | Yanira Isbet Lara | Family Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2012-06-08 |
| 1992029748 | Victoria A Edelman | Nurse Practitioner | 212 S Florida St, Bushnell, FL 33513-6703 | 2010-03-23 |
| 1255518486 | Ehrentraud Johanna Eichelbaum | General Practice | 212 S Florida St, Bushnell, FL 33513-6703 | 2008-01-30 |
| 1629278882 | Lowell F. Clark Md Pa | Internal Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2007-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619465481 | Crystal Wallace Goddin | Physical Therapy Assistant | 1104 N Main St, Bushnell, Fl, Bushnell, FL 33513 | 2018-04-27 |
| 1255836920 | Anton Dawson | Behavior Technician | 2310 Cr 615, Bushnell, FL 33513 | 2018-03-26 |
| 1942728431 | Carolyn Sue Guarino | Licensed Practical Nurse | 10306 S.w. 53rd Terr., Bushnell, FL 33513 | 2017-09-05 |
| 1326321258 | Edith Marie Evans | Case Manager/Care Coordinator | 2891 C.r. 615b, Bushnell, FL 33513 | 2011-09-27 |
| 1144478439 | Emma J Ridley | Pharmacist | Sumter Oaks Park, 4602 Couny Rd. 673, #14107, Bushnell, FL 33513 | 2008-08-29 |
| 1205083268 | Diana K Mullin | Day Training, Developmentally Disabled Services | 9325 Cr 622 G, Bushnell, FL 33513 | 2008-08-21 |
| 1467625202 | Amy's Caring Hands | Day Training, Developmentally Disabled Services | 1612 W County Road 476, Bushnell, FL 33513 | 2008-04-11 |
| 1821212952 | Stuart J Kaufman Md & Assoc Pa | Ophthalmology | 1814 West Cr 48, Bushnell, FL 33513 | 2007-04-12 |
| 1740201128 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 1122 N Main St, Bushnell, FL 33513 | 2006-07-21 |
| 1184688947 | Florida Department of Health | Public Health or Welfare | 415 E Noble Ave, Bushnell, FL 33513 | 2006-04-17 |
| Find all providers in zip 33513 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255477360 | Healthflo Medical Clinics Inc | Clinic/Center | 117 W Belt Ave, Suite A, Bushnell, FL 33513-5105 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917015 | Bonifay Rural Health Cinic | Clinic/Center | 2910 Hospital Dr Ste A, Bonifay, FL 32425-4268 | 2020-09-23 |
| 1013540947 | Clark Clinic Inc | Clinic/Center | 12620 Curley St, San Antonio, FL 33576-8136 | 2020-02-19 |
| 1023506532 | Sacred Heart Hospital On The Gulf | Clinic/Center | 805 Highway 22, Wewahitchka, FL 32465-3237 | 2018-04-30 |
| 1639693492 | Clark Clinic Inc | Clinic/Center | 910 W Myers Blvd, Mascotte, FL 34753-9748 | 2017-08-02 |
| 1194173419 | Holmes County Hospital Corporation | Clinic/Center | 5556 Brown St, Graceville, FL 32440-1007 | 2016-05-26 |
| 1568826873 | Healthvine Medical Group Inc | Clinic/Center | 725 Benton Ave, Brooksville, FL 34601-3213 | 2016-04-12 |
| 1164808465 | Family and After Hours Care, LLC | Clinic/Center | 1413 Nw 23rd Ave, Chiefland, FL 32626 | 2015-08-10 |
| 1891171914 | High Springs Pediatrics LLC. | Clinic/Center | 14900 Nw 140th St, Alachua, FL 32615-6276 | 2015-07-31 |
| 1982963344 | Sacred Heart Hospital On The Gulf | Clinic/Center | 55 Avenue 'e', Apalachicola, FL 32320-1763 | 2012-05-04 |
| 1760776900 | Sonnis Pediatrics, Inc. | Clinic/Center | 1125 S 6th Ave, Wauchula, FL 33873-3350 | 2011-06-06 |
| Find all providers with the same taxonomy | ||||
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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.