SHALITA CLARK (NPI# 1396214060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396214060 |
| Entity Type | Individual |
| Full Name | SHALITA CLARK |
| Credential | CRNP |
| Practice Address |
1108 Ross Clark Cir Dothan AL 36301-3022 |
| Mailing Address |
120 Fairlane Dr Pleasant Grove AL 35127-2741 |
| Practice Telephone | 3347123635 |
| Practice Fax Number | 3346994387 |
| Mailing Telephone | 2059360429 |
| Enumeration Date | 2018-11-24 |
| Last Update Date | 2018-11-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
1-147364 | AL | Allopathic & Osteopathic Physicians |
| Street Address |
1108 ROSS CLARK CIR |
| City | DOTHAN |
| State | AL |
| Zip Code | 36301-3022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679576268 | Judith L Bosse | Nurse Practitioner | 1108 Ross Clark Cir, Hospitalist Office, Dothan, AL 36301-3022 | 2005-05-27 |
| 1811597073 | Michael Brian Pierce | Registered Nurse | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-10-27 |
| 1659990901 | Robert Dale Garrett | Nurse Anesthetist, Certified Registered | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-04-15 |
| 1861028607 | Richard Henry Jester | Physician Assistant | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-03-12 |
| 1467017335 | Keaton Peak | Registered Nurse | 1108 Ross Clark Cir, Dothan, AL 36301 | 2019-05-07 |
| 1619452760 | Drew Mckenzie Hubbard | Registered Nurse | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2018-09-25 |
| 1609359926 | Amber Salmon | Dietitian, Registered | 1108 Ross Clark Cir, Dothan, AL 36301-3024 | 2018-09-12 |
| 1255825832 | Shannon Louette Skaug | Nurse Practitioner | 1108 Ross Clark Cir, Dothan, AL 36301-3024 | 2018-06-18 |
| 1225529712 | Vyshnavi Kone | Student in an Organized Health Care Education/Training Program | 1108 Ross Clark Cir, Dothan, AL 36301 | 2018-05-21 |
| 1811487549 | Sheila Elaine Starling | Registered Nurse | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2018-05-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1851879167 | Attallah Cotton | Social Worker | 101 Eastridge Dr, Dothan, AL 36301 | 2018-07-31 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1750805818 | Kimberly Danielle Austin | Speech-Language Pathologist | 404 Darlington Cir, Dothan, AL 36301 | 2017-07-31 |
| 1952794885 | Lori P. Granberry | Pharmacist | 2131 Ross Clark Circle, Dothan, AL 36301 | 2015-03-17 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1720407646 | Michael Kreger | Anesthesiology | 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 | 2014-04-08 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1639489313 | Robert Fort Hambaugh Jr. | Specialist | 712 Woodland Drive, Dothan, AL 36301 | 2010-10-15 |
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
| Find all providers in zip 36301 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194353672 | Jamison Behavioral Wellness LLC | Psychiatry & Neurology | 256 Honeysuckle Rd Ste 12, Dothan, AL 36305-1168 | 2020-03-30 |
| 1316444912 | Dr. Graham Psychiatric Services, LLC | Psychiatry & Neurology | 256 Honeysuckle Rd Ste 2, Dothan, AL 36305-1168 | 2018-04-10 |
| 1033495221 | Professional Resource Management of Wiregrass, LLC | Psychiatry & Neurology | 2812 Hartford Hwy Ste 1, Dothan, AL 36305 | 2011-11-01 |
| 1124325121 | Stephanie Parrish | Psychiatry & Neurology | 1672 Columbia Hwy, Dothan, AL 36303-5434 | 2011-02-28 |
| 1871749572 | Leona Jean Graham | Psychiatry & Neurology | 1865 Honeysuckle Rd Ste 2, Southeast Alabama Medical Center- Altacare, Dothan, AL 36305-4287 | 2008-08-13 |
| 1417020322 | Madeline Fay Ferrell | Psychiatry & Neurology | 114 E Troy St, Dothan, AL 36303-4844 | 2006-11-16 |
| 1629160890 | Dinesh K Karumanchi | Psychiatry & Neurology | 3753, Ste 4, Ross Clark Cir, Dothan, AL 36303-3089 | 2006-09-28 |
| 1396840047 | Medical Specialties of Dothan, PC | Psychiatry & Neurology | 207 Haven Drive, Dothan, AL 36301 | 2006-09-14 |
| 1366403255 | Sam Carroll West | Psychiatry & Neurology | 207 Haven Dr, Dothan, AL 36301-2919 | 2006-03-30 |
| 1053391581 | Dothan Psychiatric, PC | Psychiatry & Neurology | 256 Honeysuckle Rd, Suite 2, Dothan, AL 36305-1157 | 2006-01-19 |
| Find all providers in DOTHAN | ||||
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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.