JACK C CLARK (NPI# 1427092857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427092857 |
| Entity Type | Individual |
| Full Name | JACK C CLARK |
| Credential | MD |
| Practice Address |
103 Midlake Dr Knoxville TN 37918-3039 |
| Mailing Address |
1225 E Weisgarber Rd Suite 200n Knoxville TN 37909-2604 |
| Practice Telephone | 8656871973 |
| Mailing Telephone | 8655844747 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 23938 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | RR MEDICARE | 080064805 | 01 |
| TN | 3826588 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083840342 | Jack R Clark | Dentist | 1856 Lancaster Rd, Homewood, AL 35209-4114 | 2009-06-01 |
| 1265571608 | Jack Douglas Clark | Ophthalmology | 7112 N Fresno St, Suite 100, Fresno, CA 93720-2940 | 2007-02-05 |
| 1346320140 | Jack Prow Clark | Family Medicine | 518 Ems D15 Ln, Syracuse, IN 46567-8026 | 2006-10-16 |
| 1306824016 | Jack Crowley Clark Sr. | Radiology | 1431 Centerpoint Blvd, Teamhealth Radiology Ste 100, Knoxville, TN 37932-1984 | 2006-01-03 |
| 1902881014 | Jack J Clark | Chiropractor | 6015 E State Blvd, Fort Wayne, IN 46815-7638 | 2005-12-12 |
| 1477799112 | Jack Clark | Counselor | 4411 N Cedar Ave, Fresno, CA 93726-2538 | 2008-12-31 |
| 1841311487 | Jack Malcolm Clark IIi | Social Worker | 7711 Madonna, San Antonio, TX 78216-6620 | 2007-04-02 |
| 1902992837 | Jack O. Clark | Internal Medicine | 450 E Main St, Rexburg, ID 83440 | 2006-10-05 |
| 1588616882 | Jack Lewis Clark | Oral & Maxillofacial Surgery | 21700 Northwestern Hwy, Suite 1290, Southfield, MI 48075-4906 | 2006-05-16 |
| 1073563847 | Jack Clark | Internal Medicine | 1528 Del Prado Blvd S, Cape Coral, FL 33990-3798 | 2006-05-11 |
| Street Address |
103 MIDLAKE DR |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37918-3039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124069554 | Brian T Mosrie | Family Medicine | 103 Midlake Dr, Knoxville, TN 37918-3039 | 2006-06-09 |
| 1194102319 | Courtney Curington | Nurse Practitioner | 103 Midlake Dr, Knoxville, TN 37918-3039 | 2015-04-27 |
| 1629493614 | Ashley Burnett Toney | Physician Assistant | 103 Midlake Dr, Knoxville, TN 37918-3039 | 2014-02-27 |
| 1447690722 | Katherine Chilton Bellmore | Family Medicine | 103 Midlake Dr, Knoxville, TN 37918-3039 | 2013-07-01 |
| 1225477078 | Justin Wayne Quinn | Family Medicine | 103 Midlake Dr, Knoxville, TN 37918-3039 | 2013-06-14 |
| 1700199981 | Alan Douglas Haney | Family Medicine | 103 Midlake Dr, Knoxville, TN 37918-3039 | 2010-07-16 |
| 1700049178 | Whitney Day Gilliam | Nurse Practitioner | 103 Midlake Dr, Lower Level, Knoxville, TN 37918-3039 | 2008-07-07 |
| 1720152911 | Sarah Jean Levan | Nurse Practitioner | 103 Midlake Dr, Upper Level, Knoxville, TN 37918-3039 | 2006-11-20 |
| 1194896787 | Summit Medical Group, Pllc | Family Medicine | 103 Midlake Dr, Upper Level, Knoxville, TN 37918-3039 | 2006-11-13 |
| 1225117583 | Summit Medical Group, Pllc | Family Medicine | 103 Midlake Dr, Lower Level, Knoxville, TN 37918-3039 | 2006-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639636145 | Samantha Fuhrmann | Physical Therapy Assistant | Beverly Park Place Health and Rehab, 5321 Beverly Park Circle, Knoxville, TN 37918 | 2019-02-21 |
| 1043701741 | Lauren Lea Wilson | Student in an Organized Health Care Education/Training Program | 4230 Homewood Rd, Knoxville, TN 37918 | 2018-05-29 |
| 1164790317 | Jennifer Young Brooks | Pharmacist | 5006 North Broadway, Knoxville, TN 37918 | 2011-12-02 |
| 1215213194 | Lu Miller | Pharmacist | 5006 N Broadway, Knoxville, TN 37918 | 2011-10-24 |
| 1326353475 | Lauren Joy Stone | Optometrist | 4829 N Broadway St Ste 103, Knoxville, TN 37918 | 2010-08-13 |
| 1699004531 | Larry Kyle Sowder | Dentist | 2944 Tazewell Pk, Ste #2, Knoxville, TN 37918 | 2009-12-23 |
| 1922233881 | Andrea' Lamar Farrior | Dentist | 2937 Essary Rd., Dr. Michael Edenfield, Knoxville, TN 37918 | 2009-05-21 |
| 1053558510 | Love-hope Academy | Counselor | 3826 Tiberius Rd Ste 315, Knoxville, TN 37918 | 2009-01-20 |
| 1497910293 | Diana Lynn Mccoy | Psychologist | 5019 Jacksboro Pike, Knoxville, TN 37918 | 2008-07-22 |
| 1740498088 | Kathleen M Riley | Pharmacist | K-mart Pharmacy #7460, 6906 Manardville Pike Ne, Knoxville, TN 37918 | 2007-05-18 |
| Find all providers in zip 37918 | ||||
| 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 |
|---|---|---|---|---|
| 1336755271 | Maryellen Tipton | Family Medicine | 1489 Touraine Pl, Knoxville, TN 37919-8278 | 2020-09-16 |
| 1114483864 | Ucfa Physicians Network Group of Tennessee | Family Medicine | 223 Hiawassee Ave, Knoxville, TN 37917-4933 | 2019-02-19 |
| 1285199109 | Summit Medical Group,pllc | Family Medicine | 280 Ft Sanders W Blvd Ste 101, Knoxville, TN 37922-3352 | 2019-02-05 |
| 1558843235 | Geneva Lynne Worthington | Family Medicine | 135 Lovell Rd, Knoxville, TN 37934-1904 | 2018-08-30 |
| 1306325816 | Muslim Community of Knoxville's Shifa Clinic | Family Medicine | 1801 Ailor Ave, Knoxville, TN 37921-5845 | 2018-08-07 |
| 1003307422 | Dakotah Asher | Family Medicine | 4629 Mill Branch Ln, Knoxville, TN 37938-3358 | 2018-05-21 |
| 1417461211 | Lean Knox, LLC | Family Medicine | 1415 Old Weisgarber Rd. Ste 350, Knoxville, TN 37909 | 2017-12-01 |
| 1558884254 | Jck Holdings LLC | Family Medicine | 2270 Sutherland Avenue, Knoxville, TN 37919 | 2017-07-25 |
| 1982133559 | Morgan Spurlock | Family Medicine | 2519 Willow Point Way, Knoxville, TN 37931-3162 | 2017-06-07 |
| 1700332624 | Halls Physician Services, Pllc | Family Medicine | 7000 Maynardville Highway, Knoxville, TN 37918-5736 | 2016-08-31 |
| Find all providers in KNOXVILLE | ||||
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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.