DR. RUSSELL CLARK (NPI# 1538692249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538692249 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL CLARK |
| Credential | AUD |
| Practice Address |
3101 E State St Ste 2108 Eagle ID 83616-6232 |
| Practice Telephone | 2083853480 |
| Practice Fax Number | 2083853481 |
| Mailing Telephone | 2083853480 |
| Mailing Fax Number | 2083853481 |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2018-03-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | AUD-1526 | ID | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639530686 | Russell Derrick Clark | Physical Therapist | 1011 Grove Rd Ste 2a, Greenville, SC 29605-4660 | 2016-03-17 |
| 1548641087 | Russell L Clark | Nurse Practitioner | 3443 Dickerson Pike Ste 660, Nashville, TN 37207-2519 | 2015-06-10 |
| 1952554420 | Russell Clark | General Acute Care Hospital | 1412 Liatris Way, Beaumont, CA 92223-8468 | 2008-10-28 |
| 1740232156 | Russell J Clark | Specialist | Two St. Mark's Place, Ste 110, La Grange, TX 78945 | 2006-05-16 |
| 1336784578 | Russell M Clark | Counselor | 528 E Main St Ste W, John Day, OR 97845-1289 | 2019-11-12 |
| 1306060249 | Russell Adelbert Clark | Dentist | 7825 47th Ave Ne, Suite C, Marysville, WA 98270-3732 | 2007-04-12 |
| 1790787497 | Russell Patrick Clark | Emergency Medicine | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2005-08-11 |
| Street Address |
3101 E STATE ST STE 2108 |
| City | EAGLE |
| State | ID |
| Zip Code | 83616-6232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1629613823 | Counseling Solutions Center LLC | Marriage & Family Therapist | 2618 East Snocreek, Eagle, ID 83616 | 2019-11-12 |
| 1245726918 | Tracy Lyn Hagadorn | Midwife | 182 State Street, Eagle, ID 83616 | 2018-07-06 |
| 1861922627 | Nicholas A. Stelzner | Counselor | 2419 W. State St. Suite 8, Boise, ID 83616 | 2017-06-14 |
| 1184080210 | Gabriel Guerrero | Dermatology | 323 E Riverside Dr Ste 234, Eagle, ID 83616 | 2016-01-05 |
| 1376940668 | Cecilia Jo Hickam | Dental Hygienist | 1121 E. State Street, Suite - 102-d, Eagle, ID 83616 | 2014-12-02 |
| 1871912634 | Christine E Birch | Psychiatry & Neurology | 1032 S Bridgeway Pl Ste 110, Eagle, ID 83616 | 2014-04-09 |
| 1043552524 | Tori Croshaw | Social Worker | 372 S Eagle Rd Ste 190, Eagle, ID 83616 | 2013-03-21 |
| 1053650010 | Kellie Ann Northam | Nurse Practitioner | 192 West State Street, Eagle, ID 83616 | 2013-02-11 |
| 1437494457 | Mary Beth Roehling | Nurse Practitioner | 2040 E Hologate Ct, Eagle, ID 83616 | 2012-12-03 |
| Find all providers in zip 83616 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891095097 | Abram Paul Vore | Audiologist | 440 E State St Ste 100, Eagle, ID 83616-5935 | 2010-10-22 |
| 1316974702 | David Eric Morledge | Audiologist | 1020 N Beachwood Ct, Eagle, ID 83616-6929 | 2006-06-28 |
| 1730648502 | Catie Ardean Conrad | Audiologist | 440 E State St Ste 100, Eagle, ID 83616 | 2019-03-19 |
| 1083123749 | Tara Michele Schmidt | Audiologist | 440 E State St Ste 100, Eagle, ID 83616-5935 | 2017-09-26 |
| 1518383553 | Eagle Hearing LLC | Audiologist | 440 E State St Ste 100, Eagle, ID 83616-5935 | 2014-03-14 |
| 1457606832 | Jessica Ann Clark | Audiologist | 3101 E State St, Suite 2108, Eagle, ID 83616-6232 | 2012-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710502281 | Skylar M Mcsorley | Audiologist | 625 Pole Line Rd W Ste 2b, Twin Falls, ID 83301-4270 | 2020-06-10 |
| 1164080164 | Elena Stamm | Audiologist | 10000 W Amity Rd, Boise, ID 83709 | 2019-06-04 |
| 1376100966 | Mary Konneker | Audiologist | 625 Pole Line Rd W, Twin Falls, ID 83301-4268 | 2019-05-20 |
| 1518521723 | Hearing Doctors of Idaho, LLC | Audiologist | 459 Locust St N Ste 110, Twin Falls, ID 83301-7324 | 2019-04-24 |
| 1902328495 | Jacob Scott Diller | Audiologist | 5513 N Glenwood St Ste D, Boise, ID 83714-1332 | 2017-07-17 |
| 1649712597 | Angie M Mccurdy | Audiologist | 4155 Yellowstone Hwy, Pine Ridge Mall, Pocatello, ID 83202 | 2016-11-09 |
| 1083069488 | Makenzi Gwinn | Audiologist | 777 Hospital Way Ste 115, Pocatello, ID 83201-5175 | 2016-05-04 |
| 1902213945 | Sarah Jean Mooseau | Audiologist | 510 N. 2nd Street, Suite 201, Boise, ID 83702 | 2014-07-22 |
| 1184988677 | Jessica Hope Ramos | Audiologist | 2399 E Riverwalk Dr, Boise, ID 83706-5481 | 2012-06-28 |
| 1548548589 | Corrie Elizabeth Holmes | Audiologist | 650 Memorial Drive Building 68, Pocatello, ID 83209 | 2011-07-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. RUSSELL CLARK.
| 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.