DR. JACOB DANIEL CLARKE (NPI# 1467926865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467926865 |
| Entity Type | Individual |
| Full Name | DR. JACOB DANIEL CLARKE |
| Credential | MD |
| Practice Address |
1717 S Cypress St Apt 1514 Wichita KS 67207-5554 |
| Practice Telephone | 3162498596 |
| Mailing Telephone | 3162498596 |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-01-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1717 S CYPRESS ST APT 1514 |
| City | WICHITA |
| State | KS |
| Zip Code | 67207-5554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225527518 | Transition Adult Home | Day Training, Developmentally Disabled Services | 7422 E Lincoln St, Wichita, KS 67207 | 2018-05-02 |
| 1558734012 | Sonnya Natria Adams | Point of Service | 8722 Longlake Circle, Wichita, KS 67207 | 2015-11-05 |
| 1245623677 | Costco Wholesale Corporation | Pharmacy | 9700 E. Kellogg, Wichita, KS 67207 | 2015-03-10 |
| 1528468105 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 9415 East Harry Street, Bldg 800, Suite P, Wichita, KS 67207 | 2014-09-02 |
| 1962819110 | Lauren Carrillo | Marriage & Family Therapist | 111 S Whittier St Ste 1500, Wichita, KS 67207 | 2014-07-21 |
| 1962827170 | Providence Home Health & Hospice LLC. | Home Health | 9415 E Harry St Ste 703, Wichita, KS 67207 | 2014-02-25 |
| 1396089892 | Christina Rhinesmith | Speech-Language Pathologist | 12618 E Willowgreen Circle, Wichita, KS 67207 | 2012-11-21 |
| 1528360047 | Compassionate Care Home Health Agency | Home Health | 9152 Funston Ct., Wichita, KS 67207 | 2010-12-04 |
| 1477769503 | Patricia Marie Sloop | Social Worker | 1950 S. Webb Rd., Unit #121, Wichita, KS 67207 | 2007-05-15 |
| 1174738298 | Jarrod S Steffan | Psychologist | 9920 East Harry, Wichita, KS 67207 | 2007-05-11 |
| Find all providers in zip 67207 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992328678 | Madison Breanne Nigus | Student in an Organized Health Care Education/Training Program | 12526 E Central Ave Apt 2125, Wichita, KS 67206-2860 | 2020-05-28 |
| 1336762228 | Natalie Mae White | Student in an Organized Health Care Education/Training Program | 1613 S Triple Crown St, Wichita, KS 67230-7527 | 2020-05-26 |
| 1154944411 | Katty Gabriela Regalado Pastor | Student in an Organized Health Care Education/Training Program | 2549 S Maize Ct, Wichita, KS 67215-8902 | 2020-05-21 |
| 1245852839 | Katherine Gamble Flores-bailey | Student in an Organized Health Care Education/Training Program | 7450 E 32nd St N Apt 901, Wichita, KS 67226-1297 | 2020-05-18 |
| 1164050191 | Uyen Adrianne Tran | Student in an Organized Health Care Education/Training Program | 3823 N Estancia Ct, Wichita, KS 67205-8710 | 2020-03-27 |
| 1396305546 | Elijah White | Student in an Organized Health Care Education/Training Program | 1051 S Clifton Ave, Wichita, KS 67218-2910 | 2019-06-19 |
| 1932767332 | Benjamin John Lagaly | Student in an Organized Health Care Education/Training Program | 6401 W 34th St N, Wichita, KS 67205-2542 | 2019-05-31 |
| 1477110138 | Katelyn Elizabeth Gochenour | Student in an Organized Health Care Education/Training Program | 3431 E Pine St, Wichita, KS 67208-3275 | 2019-05-28 |
| 1912562869 | Sindi Vishaj | Student in an Organized Health Care Education/Training Program | North Oliver Avenue, Wichita, KS 67220 | 2019-05-07 |
| 1750862512 | Kelsi Wenger | Student in an Organized Health Care Education/Training Program | 5500 E Kellog Dr, Wichita, KS 67218 | 2018-08-28 |
| Find all providers in WICHITA | ||||
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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.