BRITTANY CLARK (NPI# 1487203451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487203451 |
| Entity Type | Individual |
| Full Name | BRITTANY CLARK |
| Credential | CAA |
| Practice Address |
220 Riverside Ave Unit 328 Jacksonville FL 32202-4953 |
| Practice Telephone | 9048741898 |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2019-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 28513458 | FL | Allopathic & Osteopathic Physicians |
| Y | 367H00000X | Anesthesiologist Assistant | AA555 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 220 Riverside Ave Unit 328, Jacksonville, FL 322024953 | 9048741898 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700285327 | Brittany Kay Clark | Nurse Practitioner | 1258 Bellefontaine St Ste A, Wapakoneta, OH 45895 | 2014-08-19 |
| 1407281538 | Brittany N. Clark | Physician Assistant | 1468 Ritter Dr, Daniels, WV 25832-9356 | 2013-09-09 |
| 1609184076 | Brittany Jo Clark | Licensed Practical Nurse | 63097 Hickory Ln, Cambridge, OH 43725-9204 | 2010-09-20 |
| 1588271381 | Brittany Leigh Clark | Nurse Practitioner | 1616 S Mustang Rd, Yukon, OK 73099-0304 | 2020-09-25 |
| 1972133569 | Brittany Antoinette Clark | Community Health Worker | 258 Old Lyman Rd, South Hadley, MA 01075-2653 | 2020-01-22 |
| 1497212617 | Brittany Nicole Clark | Occupational Therapist | 711 Susan Tart Rd, Dunn, NC 28334-5557 | 2019-02-24 |
| 1730661414 | Brittany Joyell Clark | Social Worker | 115 Liberty St, Bath, NY 14810-1508 | 2018-08-30 |
| 1205360211 | Brittany Clark | Behavior Technician | 3031 C St, Sacramento, CA 95816-3326 | 2017-04-17 |
| 1497108195 | Brittany Amber Clark | Speech-Language Pathologist | 955 Saint Peters Church Rd, Chapin, SC 29036-8197 | 2016-07-18 |
| 1669845244 | Brittany Clark | Pharmacist | 2690 E Citizens Dr, Fayetteville, AR 72703-4339 | 2015-11-04 |
| Street Address |
220 RIVERSIDE AVE UNIT 328 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32202-4953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518505411 | Dialogical Interaction Recovery, Corp. | Substance Abuse Rehabilitation Facility | 515 N. Washington Street, Jacksonville, FL 32202 | 2019-12-11 |
| 1801376629 | Shelletta Baker | Home Delivered Meals | 303 N Laura St, Jacksonville, FL 32202 | 2018-08-21 |
| 1083132591 | Shelia Yvonne Newby | Home Health Aide | 220 Riverside Ave, Unit 404, Jacksonville, FL 32202 | 2017-09-05 |
| 1164728010 | Dina Maria Fedor | Nurse Practitioner | 500 E Adams St, Jacksonville, FL 32202 | 2011-02-09 |
| 1689695611 | Maryam M Pasha | Emergency Medicine | 221 N. Hogan St, 401, Jacksonville, FL 32202 | 2006-07-23 |
| 1629174917 | Jose A Santana | Internal Medicine | 3625 University Blvd S, Emergency Department, Jacksonville, FL 32202 | 2006-09-15 |
| 1518197912 | Pleasant Living Facility, Inc. | Assisted Living Facility | 1543 Hill St, Jacksonville, FL 32202-1405 | 2009-07-20 |
| 1083803647 | Pleasant Living Facility Inc | Assisted Living Facility | 1543 Hill Street, Jax, FL 32202-1405 | 2007-10-19 |
| 1982003745 | Sheila Freeman | Social Worker | 300 E State St, Jacksonville, FL 32202-1601 | 2014-08-18 |
| 1861999625 | Bianca Holcombe | Counselor | 1010 E Adams St Ste 1111013, Jacksonville, FL 32202-1902 | 2018-04-09 |
| Find all providers in zip 32202 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992327308 | Daniel Le Phan | Anesthesiologist Assistant | 800 Prudential Dr Fl 32207, Jacksonville, FL 32207-8202 | 2020-05-08 |
| 1497395412 | Charles Joshua Thrower | Anesthesiologist Assistant | 1 Shircliff Way # Wat, Jacksonville, FL 32204-4748 | 2020-01-07 |
| 1659856862 | Ian Michael Durham | Anesthesiologist Assistant | 1 Shircliff Way Fl 32204, Jacksonville, FL 32204-4748 | 2018-10-03 |
| 1538535711 | Zeyla Rivero | Anesthesiologist Assistant | 11430 Tiara Way E, Jacksonville, FL 32223-7860 | 2015-08-11 |
| 1902206584 | Maria Williamson | Anesthesiologist Assistant | 1815 Bayard Pl, Jacksonville, FL 32205-8803 | 2014-09-02 |
| 1659705655 | Jessica Hyams Kennedy | Anesthesiologist Assistant | 820 Prudential Dr Ste 606, Jacksonville, FL 32207-8208 | 2013-08-26 |
| 1194003228 | Miguel Mancao IIi | Anesthesiologist Assistant | 10199 Southside Blvd Ste 101, Jacksonville, FL 32256-0757 | 2011-07-22 |
| 1285247411 | Victoria Potts | Anesthesiologist Assistant | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2020-08-27 |
| 1760090302 | Matthew Ryan Jones | Anesthesiologist Assistant | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-07-20 |
| 1295353407 | Taylor Rush Cowart | Anesthesiologist Assistant | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-07-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32202 |
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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.