KIMBERLY CAROL CLARK (NPI# 1538593009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538593009 |
| Entity Type | Individual |
| Full Name | KIMBERLY CAROL CLARK |
| Credential | B.S. CMT |
| Practice Address |
7901 S 12th St Suite 200 Portage MI 49024-3831 |
| Mailing Address |
8874 Pine Island Ct S Mattawan MI 49071-9570 |
| Practice Telephone | 2697206833 |
| Mailing Telephone | 2697206833 |
| Enumeration Date | 2013-09-02 |
| Last Update Date | 2013-09-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MASSAGE THERAPIST | 225700000X | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902362452 | Kimberly Michelle Clark | Technician, Other | 2819 Se Brodiaea Ct, Hillsboro, OR 97123-5201 | 2019-02-20 |
| 1780037994 | Kimberly Clark | Nurse Practitioner | 11251 Westwood Ave, Denham Springs, LA 70726-6947 | 2016-07-22 |
| 1053651869 | Kimberly Gail Clark | Hearing Instrument Specialist | 401 Apperson Dr, Salem, VA 24153-7026 | 2013-02-15 |
| 1952660524 | Kimberly Jo Clark | Licensed Practical Nurse | 334 Elmwood Ave, Barberton, OH 44203-1153 | 2012-05-16 |
| 1336421999 | Kimberly D Clark | Speech-Language Pathologist | 1524 Lexington Road, Clovis, NM 88101-6846 | 2011-09-09 |
| 1376878595 | Kimberly Clark | Physical Therapist | 101 S Kraemer Blvd Ste 125, Placentia, CA 92870-6100 | 2009-10-06 |
| 1609050913 | Kimberly Irene Clark | Counselor | 3077 Coolidge Ave, Costa Mesa, CA 92626-2809 | 2007-12-21 |
| 1053591875 | Kimberly Ann Clark | Counselor | 1516 S Boston Ave, Suite 100, Tulsa, OK 74119-4003 | 2007-11-08 |
| 1841400868 | Kimberly Clark | Social Worker | 4350 Woodland Ave, Jackson, MS 39206-3955 | 2007-05-22 |
| 1902900293 | Kimberly A Clark | Physical Therapist | 614 Monkton Rd, Bristol, VT 05443-5392 | 2006-09-08 |
| Street Address |
7901 S 12TH ST SUITE 200 |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-3831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669756912 | Kalamazoo Foot and Ankle Specialists, Plc | Podiatrist | 7901 S 12th St, Suite 101, Portage, MI 49024-3831 | 2011-10-05 |
| 1639464894 | Kelly Renee Campbell | Occupational Therapist | 7901 S 12th St, Suite #200, Portage, MI 49024-3831 | 2011-06-16 |
| 1144519133 | Jonathan Nykamp | Nurse Practitioner | 7901 S 12th St, Portage, MI 49024-3831 | 2011-03-31 |
| 1689818486 | Kimberly Clawson | Plastic Surgery | 7901 S 12th St, Portage, MI 49024 | 2009-04-23 |
| 1184886111 | Michael P Maskill | Podiatrist | 7901 S 12th St, Portage, MI 49024-3831 | 2008-07-01 |
| 1588756340 | Bryan Dale Visser | Physical Medicine & Rehabilitation | 7901 S 12th St, Suite #200, Portage, MI 49024-3831 | 2006-09-29 |
| 1609968247 | Alfonso Emanuel F Rodriguez | Physical Therapist | 7901 S 12th St, Suite #200, Portage, MI 49024-3831 | 2006-09-29 |
| 1487760427 | Great Lakes Cardiovascular Thoracic Surgery, Plc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7901 S 12th St, Suite 201, Portage, MI 49024-3831 | 2006-08-22 |
| 1356384275 | George Joseph Mack | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7901 S 12th St, Ste. 201, Portage, MI 49024-3831 | 2006-06-14 |
| 1942247176 | Sports Medicine & Joint Care of West Michigan, Plc | Orthopaedic Surgery | 7901 S 12th St, Suite 101, Portage, MI 49024-3831 | 2006-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679010342 | Kathryn Dittmer | Specialist | 3411 Airport Rd, Portage, IN 46368-5107 | 2017-01-19 |
| 1154875854 | Toni Latham | Specialist | 3215 Stonebridge Ct, Apt. 9, Portage, MI 49024-8000 | 2016-08-10 |
| 1194999896 | Lakeshore Bone & Joint Institute, PC | Specialist | 3691 Willowcreek Rd, Portage, IN 46368-5076 | 2008-04-15 |
| 1093924615 | Christine Jubina | Specialist | 394 Golf Course Rd, Portage, PA 15946-6018 | 2007-05-21 |
| 1245452481 | Plastic Surgery of Kalamazoo,pc | Specialist | 7901 South 12th Street, Suite 100, Portage, MI 49024 | 2007-05-03 |
| 1891914867 | Hickner Eye Center, P.C. | Specialist | 1906 W Milham Ave, Portage, MI 49024 | 2007-04-25 |
| 1740308964 | David R Areaux | Specialist | West Michigan Ear, Nose & Throat, 3850 Glenkerry Court, Portage, MI 49024 | 2007-03-26 |
| 1063440311 | Larry R Walton | Specialist | 1220 West Milham Ave, Portage, MI 49024-1206 | 2006-06-28 |
| 1104277672 | Samantha Kohn | Specialist | 9616 Portage Rd, Portage, MI 49002-7257 | 2016-06-27 |
| 1164873618 | Hannah Patricia Christensen | Specialist | 9616 Portage Rd, Portage, MI 49002-7257 | 2016-06-27 |
| Find all providers in PORTAGE | ||||
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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.