MR. KENNETH DALE CLARK (NPI# 1598046401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1598046401 |
Entity Type | Individual |
Full Name | MR. KENNETH DALE CLARK |
Practice Address |
9303 Pinecroft Dr The Woodlands TX 77380-3181 |
Practice Telephone | 2812976445 |
Practice Fax Number | 2812976460 |
Mailing Telephone | 2812976445 |
Mailing Fax Number | 2812976460 |
Enumeration Date | 2011-09-06 |
Last Update Date | 2011-09-27 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 222Z00000X | Orthotist | 400 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | GROUP MEDICARE NUMBER | 00J21A | 01 |
TX | GROUP MEDICAID NUMBER | 094010801 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275056889 | Kenneth Clark | Hearing Instrument Specialist | 304 E Broadway St Ste 20, Mount Pleasant, MI 48858-2364 | 2017-07-25 |
1063887834 | Kenneth Eugene Clark | Occupational Therapy Assistant | 4885 Eldon Dr S, Colorado Springs, CO 80916-4431 | 2015-12-04 |
1821119959 | Kenneth R Clark | Pharmacist | 4211 Hospital St Ste 104, Pascagoula, MS 39581-5310 | 2007-04-03 |
1104487149 | Kenneth John Clark | Hearing Instrument Specialist | 462 Roosevelt Rd, Glen Ellyn, IL 60137-5611 | 2019-06-20 |
1144740580 | Kenneth John Clark Jr. | Physical Therapist | 6119 Deltona Blvd, Spring Hill, FL 34606-1011 | 2017-06-27 |
1619336229 | Kenneth Clark | Dentist | 2524 Hillside Heights Dr, Green Bay, WI 54311-6777 | 2016-02-11 |
1669878443 | Kenneth Clark | Registered Nurse | 724 N Charlotte St, Pottstown, PA 19464-4607 | 2014-11-06 |
1093012783 | Kenneth Howard Clark | Pathology | 200 Lothrop St, Pittsburgh, PA 15213-2536 | 2011-02-16 |
1568794725 | Kenneth Andrew Clark II | Marriage & Family Therapist | 10800 Financial Centre Pkwy Ste 290, Little Rock, AR 72211-3581 | 2010-02-12 |
1942344031 | Kenneth L Clark | Registered Nurse | 2640 Breslauer Way, Redding, CA 96001-4246 | 2007-02-20 |
Street Address |
9303 PINECROFT DR |
City | THE WOODLANDS |
State | TX |
Zip Code | 77380-3181 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689669525 | Mouhamed Hazem El Zufari | Family Medicine | 9303 Pinecroft Dr, Suite 340, The Woodlands, TX 77380-3181 | 2005-09-16 |
1508232299 | Lonestar Spine Specialists Pllc | Physical Medicine & Rehabilitation | 9303 Pinecroft Dr, Suite 320, The Woodlands, TX 77380-3181 | 2015-08-17 |
1679959779 | Pain Addiction Consultants, Pllc | Anesthesiology | 9303 Pinecroft Dr, Suite 320, The Woodlands, TX 77380-3181 | 2015-07-31 |
1285027326 | Lone Star Vein Centers, P.a. | Surgery | 9303 Pinecroft Dr, Suite 350, The Woodlands, TX 77380-3181 | 2015-03-13 |
1174928550 | Fiant Wellness Group | Anesthesiology | 9303 Pinecroft Dr, Suite 320, The Woodlands, TX 77380-3181 | 2014-10-28 |
1386985711 | Gabbrielle Ann Williams | Chiropractor | 9303 Pinecroft Dr, Suite 200, The Woodlands, TX 77380-3181 | 2013-03-11 |
1609199876 | Shane O Smith | Physician Assistant | 9303 Pinecroft Dr, Suite 320, The Woodlands, TX 77380-3181 | 2010-03-02 |
1437324480 | Mandy Sue Harting | Dermatology | 9303 Pinecroft Dr, Suite 150, The Woodlands, TX 77380-3181 | 2008-04-29 |
1154595270 | Ryan O'neill Mcdonald | Psychiatry & Neurology | 9303 Pinecroft Dr, Suite 270, The Woodlands, TX 77380-3181 | 2008-04-18 |
1740484872 | Jeffrey Ronald Cain | Physical Therapist | 9303 Pinecroft Dr, The Woodlands, TX 77380-3181 | 2007-06-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952874034 | Elevated Neuro LLC | Specialist/Technologist, Other | 719 Sawdust Rd Ste 213, The Woodlands, TX 77380 | 2019-01-10 |
1588139851 | Sara Barchie | Dietitian, Registered | 26113 Oak Ridge Drive, Suite A, The Woodlands, TX 77380 | 2018-10-12 |
1730664988 | Global Bionics, LLC | Durable Medical Equipment & Medical Supplies | 1001 Medical Loop, Ste 220, Spring, TX 77380 | 2018-10-03 |
1104309350 | Kristina Nicole Zills | Psychologist | 26205 Oak Ridge Dr. Suite 103, The Woodlands, TX 77380 | 2018-09-13 |
1972094365 | Southern Texas Allergy The Woodlands | Allergy & Immunology | 9191 Pinecroft Dr Ste 290, Shenandoah, TX 77380 | 2018-05-22 |
1609373992 | Joy Adaku Ekwueme | Nurse Practitioner | Main Street Medical Clinic, 1120 Medical Plaza Dr, Suite 335, Shenandoah, TX 77380 | 2018-04-12 |
1821517103 | Catalyst Medical Suites, LLC | Clinic/Center | 1544 Sawdust Rd Ste 280, Spring, TX 77380 | 2017-09-18 |
1114440898 | Elanor Sung | Massage Therapist | 26103 I 45, Ste 102, The Woodlands, TX 77380 | 2017-07-25 |
1043732555 | Chinyere Obiakwata | Nurse Practitioner | 201 Pruitt Rd Apt 430, Spring, TX 77380 | 2017-07-17 |
1295261055 | Nafeiza Persaud | Counselor | 25301 Borough Park Dr Ste 125, Spring, TX 77380 | 2017-05-11 |
Find all providers in zip 77380 |
Taxonomy Code | 222Z00000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Orthotist |
A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548869225 | Anna Christine Brown | Orthotist | 12880 Hillcrest Rd Ste J216, Dallas, TX 75230-1532 | 2020-10-22 |
1861009912 | Sarah Spinelli | Orthotist | 555 D Round Rock West Drive, Suite 100, Round Rock, TX 78681 | 2020-09-23 |
1639713597 | Amanda Coldren | Orthotist | 6011 Harry Hines Blvd Ste 302, Dallas, TX 75235-5386 | 2019-11-04 |
1184266785 | Duran H Pardue | Orthotist | 6011 Harry Hines Blvd Fl 2, Dallas, TX 75235-5386 | 2019-10-15 |
1326692351 | Steven Gomez Herrera Sr. | Orthotist | 7410 John Smith Dr Ste 213, San Antonio, TX 78229-6000 | 2019-07-29 |
1669034831 | Madeline Maya Gougeon | Orthotist | Hope Orthotics, LLC - Attn: Maya Gougeon, Lo, 230 Spring Hill Drive, Suite 335, Spring, TX 77386-2388 | 2019-07-08 |
1275048852 | Phuoc Nguyen | Orthotist | 1721 W Plano Pkwy Ste 212, Plano, TX 75075 | 2017-12-05 |
1316452147 | Abigail Catherine Genet | Orthotist | 6011 Harry Hines Blvd Suite V5.400, Dallas, TX 75390-0001 | 2017-12-01 |
1407370414 | Katelyn Suzanne Cummings | Orthotist | 230 Spring Hill Dr Ste 335, Spring, TX 77386-2388 | 2017-08-01 |
1154843647 | Nicholas Robison Brown | Orthotist | 6011 Harry Hines Blvd Ste V2302, Dallas, TX 75235-5386 | 2017-07-17 |
Find all providers with the same taxonomy |
City | THE WOODLANDS |
Zip Code | 77380 |
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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.