JUSTIN PATRICK CLARK (NPI# 1609135011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609135011 |
| Entity Type | Individual |
| Full Name | JUSTIN PATRICK CLARK |
| Credential | M.D. |
| Practice Address |
2212 W Kearney St Springfield MO 65803-2029 |
| Mailing Address |
Po Box 505164 Saint Louis MO 63150-5164 |
| Practice Telephone | 4178318074 |
| Practice Fax Number | 4178646585 |
| Mailing Telephone | 4178294620 |
| Mailing Fax Number | 4178294316 |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2015-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2015027593 | MO | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | TRN17208 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1609135011 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493226 | Justin Clark | Student in an Organized Health Care Education/Training Program | 7337 Wythe Dr, Noblesville, IN 46062-7785 | 2020-10-08 |
| 1942531868 | Justin Clark | Pharmacist | 12050 N Dove Mt Blvd, Marana, AZ 85658 | 2010-01-15 |
| 1750528964 | Justin Liam Clark | Physical Therapist | 102 Fairview Pk Dr, Elmsford, NY 10523-1518 | 2009-01-09 |
| 1598945644 | Justin Charles Clark | Neurological Surgery | 414 Plymouth Ne, Grand Rapids, MI 49505-6041 | 2007-11-06 |
| 1538129085 | Justin Clark | Allergy & Immunology | 362 Beal Pkwy Nw Ste 105, Fort Walton Beach, FL 32548-3926 | 2006-03-27 |
| 1639164098 | Justin Wayne Clark | Dermatology | 3601 22nd St, Lubbock Dermatology, Lubbock, TX 79410-1309 | 2005-09-13 |
| 1619458999 | Justin Blake Clark | Social Worker | 9600 Veterans Dr., Mailstop: Mhc 61-116-c, Tacoma, WA 98493-5000 | 2018-08-24 |
| 1912483645 | Justin D Clark | Social Worker | 533 26th St Ste 100, Ogden, UT 84401-2459 | 2018-07-16 |
| 1235621327 | Justin M Clark | Family Medicine | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2018-06-04 |
| 1760987481 | Justin Clark | Occupational Therapist | 14151 15 Mile Rd, Sterling Heights, MI 48312-5507 | 2018-03-26 |
| Street Address |
2212 W KEARNEY ST |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65803-2029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871632422 | Oran J Ringen | Family Medicine | 2212 W Kearney St, Springfield, MO 65803-2029 | 2007-02-06 |
| 1558726034 | Melissa Rowland | Nurse Practitioner | 2212 W Kearney St, Springfield, MO 65803-2029 | 2015-12-28 |
| 1841427515 | Sheri Lynn Bethmann | Family Medicine | 2212 W Kearney St, Springfield, MO 65803-2029 | 2009-06-19 |
| 1578760120 | St. John's Physicians & Clinics, Inc. | Durable Medical Equipment & Medical Supplies | 2212 W Kearney St, Springfield, MO 65803-2029 | 2007-06-28 |
| 1437278181 | Joanna Kluch | Family Medicine | 2212 W Kearney St, Springfield, MO 65803-2029 | 2007-03-27 |
| 1487793022 | Scott A Galligos | Family Medicine | 2212 W Kearney St, Springfield, MO 65803-2029 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104448216 | Kathleen Gail Newell-lewis | Registered Nurse | 2345 E. Cherokee, Springfield, MO 65803 | 2020-05-12 |
| 1285145730 | Meghan Roetto | Social Worker | 2130 N Glenstone, Springfield, MO 65803 | 2017-10-23 |
| 1346751757 | John B Lehn | Pharmacist | 2625 N Kansas Expressway, Springfield, MO 65803 | 2017-10-12 |
| 1558805754 | Bhg Xliii, LLC | Clinic/Center | 2551 W Kearney St, Springfield, MO 65803 | 2016-12-07 |
| 1962856187 | Karissa Knight | Counselor | 2438 N Cottage, Springfield, MO 65803 | 2016-04-14 |
| 1417383290 | Walgreens | Community/Behavioral Health | 1525 W Kearny, Springfield, MO 65803 | 2013-09-24 |
| 1790123479 | Sarah Fontana | Dentist | 2241 N. Glenstone Ave., Springfield, MO 65803 | 2013-06-04 |
| 1942499587 | Jeci Mora Ramos Jr. | Hearing Instrument Specialist | 2133 N Nettleton, Springfield, MO 65803 | 2007-10-19 |
| 1598891012 | Dwight Richard Daugherty | Dentist | 3016 N Kentwood, Springfield, MO 65803 | 2007-02-26 |
| 1144388224 | Bradley Douglas Graf | Dentist | 1410 E Kearney, Suite A, Springfield, MO 65803 | 2006-12-04 |
| Find all providers in zip 65803 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649815796 | 180 Health Lifestyle Wellness Centers | Family Medicine | 1936 S Glenstone Ave, Springfield, MO 65804-2305 | 2019-11-13 |
| 1790337988 | Aminat Ogun | Family Medicine | 520 N 4th St # 62702, Springfield, IL 62702-5238 | 2019-07-09 |
| 1770076622 | Thomas John Schumann | Family Medicine | 1260 E. Woodlawn Ave, Suite 200, Springfield, PA 19064-3988 | 2018-06-14 |
| 1134648959 | Patricia Derges | Family Medicine | 3259 E Sunshine St Ste Aa, Springfield, MO 65804-2114 | 2017-09-12 |
| 1740704667 | Mercy Management of Sepa | Family Medicine | 1001 Baltimore Pike Ste 109, Springfield, PA 19064-2852 | 2017-08-02 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1790215853 | Vincent Marchese | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2017-06-12 |
| 1184152100 | Canaan Arceneaux | Family Medicine | 1001 Baltimore Pike Ste 106, Springfield, PA 19064-2800 | 2017-06-03 |
| 1063943587 | Cody Stark Rogers | Family Medicine | 1423 N Jefferson Ave # A100, Springfield, MO 65802-1988 | 2017-03-26 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65803 |
Please comment or provide details below to improve the information on JUSTIN PATRICK 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.