KELLY CLARK (NPI# 1568883312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568883312 |
| Entity Type | Individual |
| Full Name | KELLY CLARK |
| Practice Address |
125 W Bartlette St Apt. 110 Sumter SC 29150-5173 |
| Practice Telephone | 8032366727 |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2013-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | PR31930 | SC | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861026650 | Kelly Ann Clark | Nurse Practitioner | 4590 Childrens Pl, Saint Louis, MO 63110-1020 | 2020-03-02 |
| 1013474410 | Kelly Patricia Clark | Licensed Practical Nurse | 55 Pine Dr E, Mason, MI 48854-9229 | 2019-02-22 |
| 1013497304 | Kelly Ann Clark | Case Manager/Care Coordinator | 2498 Wenona Dr, Wixom, MI 48393-2199 | 2018-08-16 |
| 1407336720 | Kelly Elizabeth Clark | Physical Medicine & Rehabilitation | 3800 Reservoir Rd., Bles Building, Ground Floor, Department of Pm&r, Washington, DC 20007-2113 | 2018-08-16 |
| 1356747448 | Kelly Clark | Dietitian, Registered | 46 Mallards Cv, Duxbury, MA 02332-3548 | 2014-11-17 |
| 1306105903 | Kelly Thomas Clark | Speech-Language Pathologist | 3406 Fowler Ct, Missouri City, TX 77459-6366 | 2012-05-16 |
| 1619247509 | Kelly Jane Clark | Pharmacist | 328 Quail Walk Trl, Chapin, SC 29036-9791 | 2012-01-09 |
| 1427350461 | Kelly Darlene Clark | Chiropractor | 2425 Mahan Dr, Tallahassee, FL 32308-2301 | 2010-11-24 |
| 1538479324 | Kelly S Clark | Licensed Vocational Nurse | 15716 W High St # 597, Middlefield, OH 44062-9201 | 2010-10-14 |
| 1881715068 | Kelly Clark | Social Worker | 425 Prospect St, Northampton, MA 01060-2046 | 2007-04-03 |
| Street Address |
125 W BARTLETTE ST APT. 110 |
| City | SUMTER |
| State | SC |
| Zip Code | 29150-5173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174152557 | Stacey Delene Mcconico | Adult Companion | 201 East Liberty Street, Sumter, SC 29150 | 2020-04-07 |
| 1780227942 | Add Light Home Care LLC | In Home Supportive Care | 698-s Bultman Dr, Suite C-8, Sumter, SC 29150 | 2019-10-21 |
| 1770044075 | Kimberly A Weeks | Technician, Other | 5 E Liberty Street, Sumter, SC 29150 | 2019-03-28 |
| 1689155103 | Chrishena E Craig | Social Worker | 801 N. Pike West, Sumter, SC 29150 | 2018-08-23 |
| 1093200735 | Michael B Coseo | Dietitian, Registered | 1278 N. Lafayette Drive, Sumter, SC 29150 | 2018-06-26 |
| 1790287258 | Keever Murdaugh | Physical Therapy Assistant | 1018 North Guignard Drive, Sumter, SC 29150 | 2018-03-01 |
| 1679094643 | James D Pearson | Emergency Medical Technician, Basic | 9b Willow Drive, Sumter, SC 29150 | 2017-06-29 |
| 1245771781 | Shanekia Littles | In Home Supportive Care | 251 Rast St Unit D-1, Sumter, SC 29150 | 2017-03-16 |
| 1326590415 | Believe In Faith Home Care | In Home Supportive Care | 410 W Liberty St Suite 102, Sumter, SC 29150 | 2016-10-25 |
| 1912368457 | Urology Clinic, Inc. | Urology | 1285 Wilson Hall Rd, Sumter, SC 29150 | 2016-03-11 |
| Find all providers in zip 29150 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235785924 | Melba G. Payne | Licensed Practical Nurse | 4171 Champagne Ln, Sumter, SC 29153-7795 | 2019-08-17 |
| 1326551300 | Denise Burns Ahtonen | Licensed Practical Nurse | 485 Pioneer Dr, Sumter, SC 29150-9541 | 2017-11-13 |
| 1003033143 | Nancy Shannon Paterna | Licensed Practical Nurse | 2200 Lloyd Dr, Sumter, SC 29154-8819 | 2007-04-19 |
| 1700203460 | Teresa Walls | Licensed Practical Nurse | 105 N Magnolia St, Sumter Co Health Dept, Sumter, SC 29150-4941 | 2014-03-19 |
| 1578511986 | Sherry A. Grainger | Licensed Practical Nurse | 215 N. Magnolia St., Swcmhc, Sumter, SC 29151-1946 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316911 | Marlesia Hall | Licensed Practical Nurse | 106 Teal Dr, Easley, SC 29642 | 2020-11-06 |
| 1750982674 | Coco Carter | Licensed Practical Nurse | 210 Helen St, Piedmont, SC 29673 | 2020-11-06 |
| 1265032015 | Dorothy Angela Parson | Licensed Practical Nurse | 1000 Hillsborough Dr Apt 54, Seneca, SC 29678-3762 | 2020-10-30 |
| 1023621182 | Twila Beckman | Licensed Practical Nurse | 1011 Mimosa Ct, Conway, SC 29527-5919 | 2020-08-28 |
| 1932712320 | Amy Marie Bleier | Licensed Practical Nurse | 2470 Mall Dr Ste C&d, North Charleston, SC 29406-6514 | 2020-08-26 |
| 1689283616 | Destinee Watson | Licensed Practical Nurse | 3003 S Canal Dr, Florence, SC 29505-7503 | 2020-07-27 |
| 1407487127 | Michelle Thompson | Licensed Practical Nurse | 1113 Belleview St Ste 103, Columbia, SC 29201-1839 | 2020-01-31 |
| 1992345961 | Katherine Elizabeth Clark | Licensed Practical Nurse | 764 Patriot Pkwy Apt 203, Rock Hill, SC 29730-2750 | 2020-01-08 |
| 1376188334 | Emily Price Blackwell | Licensed Practical Nurse | 420 High Point Church Rd, Pageland, SC 29728-6458 | 2019-11-14 |
| 1053956383 | Judy R Riley | Licensed Practical Nurse | 1615 Blewer Rd, Cope, SC 29038-9330 | 2019-11-11 |
| Find all providers with the same taxonomy | ||||
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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.