KELLY SUE CLARK (NPI# 1598253361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598253361 |
| Entity Type | Individual |
| Full Name | KELLY SUE CLARK |
| Credential | REGISTERED NURSE |
| Practice Address |
28 Chick St Metropolis IL 62960-2467 |
| Mailing Address |
320 Lindsey Ave Metropolis IL 62960-1162 |
| Practice Telephone | 6185242176 |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2018-04-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | 041405442 | IL | 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 |
| 1568883312 | Kelly Clark | Licensed Practical Nurse | 125 W Bartlette St, Apt. 110, Sumter, SC 29150-5173 | 2013-12-20 |
| 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 |
| Street Address |
28 CHICK ST |
| City | METROPOLIS |
| State | IL |
| Zip Code | 62960-2467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790788578 | Massac Memorial Hospital | General Acute Care Hospital | 28 Chick St, Metropolis, IL 62960-2467 | 2005-05-24 |
| 1235772328 | Kincaid King Physician Services, P.C. | Physician Assistant | 28 Chick St, Metropolis, IL 62960-2467 | 2019-10-22 |
| 1104283035 | Massac Ems | Ambulance | 28 Chick St, Metropolis, IL 62960-2467 | 2016-01-22 |
| 1801159835 | Jennifer Shoemate | Speech-Language Pathologist | 28 Chick St, Metropolis, IL 62960-2467 | 2012-06-25 |
| 1952663254 | Lori Miller | Physical Therapist | 28 Chick St, Metropolis, IL 62960-2467 | 2012-06-12 |
| 1942531835 | Michael J. & Beverly Hicks | Audiologist | 28 Chick St, Metropolis, IL 62960-2467 | 2010-01-17 |
| 1861633380 | Illinois Emergency Physicians LLP | Emergency Medicine | 28 Chick St, Metropolis, IL 62960-2467 | 2009-03-12 |
| 1780851428 | Eileen Patrice Laurence | Emergency Medicine | 28 Chick St, Metropolis, IL 62960-2467 | 2008-05-12 |
| 1417142449 | Michael Joe Hicks | Audiologist | 28 Chick St, Metropolis, IL 62960-2467 | 2007-09-12 |
| 1831226901 | Massac Memorial Hospital | Medicare Defined Swing Bed Unit | 28 Chick St, Metropolis, IL 62960-2467 | 2007-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972069078 | Amber Nicole Garcia | Social Worker | 205 W 5th Street, Metropolis, IL 62960 | 2019-02-13 |
| 1407251622 | Massac County Surgery Center LLC | Clinic/Center | 1811 E 5th St, Metropolis, IL 62960 | 2014-10-30 |
| 1750535761 | Robert Hays Bryan | Dentist | 805 Market St., Metropolis, IL 62960 | 2008-11-05 |
| 1518144682 | Rebecca Louise Mcquage | Counselor | 206 West 5th St, Metropolis, IL 62960 | 2008-01-30 |
| 1154640902 | Syed S Kazmi | Family Medicine | 12 Hospital Drive, Metropolis, IL 62960 | 2007-04-20 |
| 1083736680 | Bharat K Patel Sc | Internal Medicine | 12 Hospital Dr., Memorial Heights, Metropolis, IL 62960 | 2007-04-04 |
| 1467594747 | Peggy Sue Legereit | Speech-Language Pathologist | 3037 Lakeview Dr, Metropolis, IL 62960 | 2007-02-13 |
| 1821150475 | Ruth E Johnson | Counselor | 206 West 5th, Metropolis, IL 62960 | 2006-12-13 |
| 1720140379 | James Allen Haley | Counselor | 206 West 5th Street, Metropolis, IL 62960 | 2006-12-13 |
| 1659432185 | Gary T Brush | Optometrist | 1801 E 5th Street, Metropolis, IL 62960 | 2006-12-12 |
| Find all providers in zip 62960 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and 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 |
|---|---|---|---|---|
| 1558962720 | Christine Nance | Registered Nurse | 125 W 109th St, Chicago, IL 60628-3432 | 2020-11-04 |
| 1538769773 | Erica Guerrero | Registered Nurse | 1071 W 15th St Unit 202, Chicago, IL 60608-2783 | 2020-10-27 |
| 1306446836 | Amir W Raad | Registered Nurse | 5613 Dunham Rd, Downers Grove, IL 60516-1247 | 2020-10-26 |
| 1083213037 | Johanna Gordon | Registered Nurse | 820 Timbers Edge Ln, Northbrook, IL 60062-3100 | 2020-10-21 |
| 1457959470 | Gretchen Marie Clavey | Registered Nurse | 1711 Mayfair Rd, Champaign, IL 61821-5522 | 2020-10-12 |
| 1336747526 | Samantha Cappetto | Registered Nurse | 437 Thomas Jefferson Ct, Aurora, IL 60504-2013 | 2020-10-11 |
| 1508464736 | Jessica Young | Registered Nurse | 2648 W 21st St Apt 2f, Chicago, IL 60608-4080 | 2020-10-10 |
| 1912514654 | Marlon Viloria | Registered Nurse | 4557 Jenna Rd, Glenview, IL 60025-1403 | 2020-09-27 |
| 1114534047 | Sheri Pierce | Registered Nurse | 24513 S Serrano Ct, Channahon, IL 60410-5289 | 2020-09-24 |
| 1396351961 | Jasmin Rose Joy | Registered Nurse | 1761 E Corktree Ln, Mount Prospect, IL 60056-1859 | 2020-09-19 |
| Find all providers with the same taxonomy | ||||
| City | METROPOLIS |
| Zip Code | 62960 |
Please comment or provide details below to improve the information on KELLY SUE 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.