CHRISTOPHER MARVIN CLARK (NPI# 1487297065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487297065 |
| Entity Type | Individual |
| Full Name | CHRISTOPHER MARVIN CLARK |
| Credential | ATC |
| Practice Address |
700 Pelham Rd N Jacksonville AL 36265-1602 |
| Mailing Address |
1151 Lake Forest Dr N Southside AL 35907-7111 |
| Practice Telephone | 2567825514 |
| Practice Fax Number | 2567825546 |
| Mailing Telephone | 2566132384 |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2019-10-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
857 | AL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194286955 | Christopher James Clark | Student in an Organized Health Care Education/Training Program | 2390 W Congress St # 2, Lafayette, LA 70506-4205 | 2019-03-26 |
| 1801383351 | Christopher Clark | Case Management | 43a Richfield Rd, Upper Darby, PA 19082-2517 | 2018-04-20 |
| 1285088385 | Christopher Clark | Occupational Therapist | 101 Applied Bank Blvd Ste D4, Glen Mills, PA 19342 | 2016-04-15 |
| 1912322694 | Christopher W Clark | Military Health Care Provider | G544 C Street, Camp Lejuene, NC 28542 | 2014-03-04 |
| 1144657248 | Christopher Alex Clark | Counselor | 900 Corbitt Dr, Wilmore, KY 40390-1096 | 2013-10-03 |
| 1427480490 | Christopher James Clark | Counselor | 2817 E 97th Pl Apt 1506, Tulsa, OK 74137-7334 | 2013-08-01 |
| 1912341892 | Christopher Michael Clark | Otolaryngology | 48 Medical Park Dr E Ste 153, Birmingham, AL 35235-3459 | 2013-04-23 |
| 1992053474 | Christopher Tad Clark | Counselor | 1471 Dewar Dr Ste 204, Rock Springs, WY 82901-5826 | 2012-08-15 |
| 1215257217 | Christopher David Clark | Physical Medicine & Rehabilitation | 1165 Imperial Dr Ste 103, Hagerstown, MD 21740-6555 | 2010-06-02 |
| 1497983332 | Christopher Lee Clark | Military Health Care Provider | 5179 Malmstrom Ave, Nellis Afb, NV 89191-6126 | 2009-06-30 |
| Street Address |
700 PELHAM RD N |
| City | JACKSONVILLE |
| State | AL |
| Zip Code | 36265-1602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669882569 | Makenzie W. Bayles | Behavioral Analyst | 700 Pelham Rd N, Jsu - Psychology Department, Jacksonville, AL 36265-1602 | 2014-04-30 |
| 1568026375 | Rebecca Katherine Nation | Specialist/Technologist | 700 Pelham Rd N, Jacksonville, AL 36265-1623 | 2019-04-26 |
| 1912486929 | Savannah Rose Barrentine | Specialist/Technologist | 700 Pelham Rd N, Jacksonville, AL 36265-1602 | 2018-08-09 |
| 1104336627 | Michael Garrett Polascik | Specialist/Technologist | 700 Pelham Rd N, Jacksonville, AL 36265-1602 | 2017-10-11 |
| 1275043895 | Michaela Grace Meadows | Physical Medicine & Rehabilitation | 700 Pelham Rd N, Jacksonville, AL 36265-1602 | 2017-10-10 |
| 1497264659 | Jonathan Griffith | Specialist/Technologist | 700 Pelham Rd N, Jacksonville, AL 36265-1602 | 2017-09-20 |
| 1003325275 | Jenah Tracy | Specialist/Technologist | 700 Pelham Rd N, Jacksonville, AL 36265-1602 | 2017-09-20 |
| 1275042426 | Dustin Hill | Specialist/Technologist | 700 Pelham Rd N, Jacksonville, AL 36265-1602 | 2017-09-20 |
| 1346776952 | Summer Allen | Prevention Professional | 700 Pelham Rd N, Jacksonville, AL 36265-1602 | 2017-05-03 |
| 1548717119 | Jacksonville State University | Family Medicine | 700 Pelham Rd N, Jacksonville, AL 36265-1602 | 2016-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700436144 | Griffin Loflin | Specialist/Technologist | 775 Park Ave Nw, Attn. Sports Medicine, Jacksonville, AL 36265 | 2019-09-17 |
| 1114304011 | Caroline Ross | Counselor | 1215 Jackson Way Sw, Jacksonville, AL 36265 | 2015-04-29 |
| 1083001226 | Tracey Hudgins | Counselor | 1215 Jackson's Way, Jacksonville, AL 36265 | 2015-04-24 |
| 1235415118 | Adam Pike | Pharmacist | 311 Pelham Rd So, Jacksonville, AL 36265 | 2011-10-24 |
| 1386829489 | Physicians Choice Dialysis of Jacksonville, LLC | Clinic/Center | 331 Henry Road Sw, Jacksonville, AL 36265 | 2008-01-08 |
| 1659409365 | Kenneth Wayne Campbell | Nurse Anesthetist, Certified Registered | 1701 Pelham Road, Jacksonville Medical Center, Jacksonville, AL 36265 | 2007-03-02 |
| 1154478378 | Diana C. Ford | Counselor | 1250 Jackson's Way, Garrett Counseling Center, Jacksonville, AL 36265 | 2007-01-03 |
| 1487710950 | James Richard Morrison | Chiropractor | 1550 Pelham Rd. S., Jacksonville, AL 36265 | 2006-12-29 |
| 1447332937 | Millennium Anesthesia Services | Anesthesiology | 1701 Pelham Road S, Jacksonville, AL 36265 | 2006-10-20 |
| 1407943228 | Brunda Revanna, Md | Clinic/Center | 1465 A 1st Ave Sw Ste C, Jacksonville, AL 36265 | 2006-10-05 |
| Find all providers in zip 36265 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003423880 | Amber Simerly Magliocca | Specialist/Technologist | 410 New Bridge St Ste 7b, Jacksonville, NC 28540-4759 | 2020-09-25 |
| 1730717091 | Bryan M Langan | Specialist/Technologist | 8 Sunnydale Ave, Jacksonville, IL 62650-2656 | 2020-03-31 |
| 1184257065 | Tory Ann Cooper | Specialist/Technologist | 8136 Pine Springs Ln, Jacksonville, FL 32244-7445 | 2020-02-19 |
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1194360008 | Shaylee Jade Fouts | Specialist/Technologist | 1210 Corinth Rd, Jacksonville, TX 75766-3208 | 2019-11-14 |
| 1700436144 | Griffin Loflin | Specialist/Technologist | 775 Park Ave Nw, Attn. Sports Medicine, Jacksonville, AL 36265 | 2019-09-17 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1639733975 | Logen Izzak Hirn | Specialist/Technologist | 141 Lakewood Dr, Jacksonville, NC 28546-4633 | 2019-04-23 |
| 1568924348 | Thomas Bradley Vickers | Specialist/Technologist | 11911 Cornelius St, Jacksonville, FL 32246-4004 | 2019-04-02 |
| 1063971729 | Leonardo Sierra | Specialist/Technologist | 11057 Stutz Ct, Jacksonville, FL 32246-1401 | 2019-03-13 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 36265 |
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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.