MR. DAVID JOSEPH CLARK (NPI# 1619022563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619022563 |
| Entity Type | Individual |
| Full Name | MR. DAVID JOSEPH CLARK |
| Credential | PHARMD |
| Practice Address |
2101 Elm St N Fargo ND 58102-2417 |
| Mailing Address |
2540 14th St S #312 Fargo ND 58103-5616 |
| Practice Telephone | 7012323241 |
| Mailing Telephone | 7012399675 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 4507 | ND | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225388531 | David Clark | Pharmacist | 87 Garner Rd., Cvs 4174, Spartanburg, SC 29303 | 2012-09-13 |
| 1568778793 | David F Clark | Social Worker | 4425 S Jones Blvd, Suite D3, Las Vegas, NV 89103-3370 | 2010-08-25 |
| 1407093065 | David E. Clark | Dietitian, Registered | 4132 Sierra Park Ter, Dayton, OH 45440-3324 | 2009-01-19 |
| 1962668202 | David Allen Clark | Dentist | 4209 Tieton Dr, Suite 102, Yakima, WA 98908-3377 | 2008-08-06 |
| 1548427693 | David Kyle Clark | Dentist | 2120 Bert Kouns Loop Ste D, Shreveport, LA 71118-3351 | 2008-05-16 |
| 1790957603 | David C. Clark | Pharmacist | 1215 Route 31, Macedon, NY 14502-9763 | 2008-03-31 |
| 1275722365 | David Allan Clark | Counselor | 50196 872nd Rd, Page, NE 68766-5539 | 2007-10-15 |
| 1649488214 | David D Clark | Chiropractor | 2573 N Reading Rd, Denver, PA 17517-9333 | 2007-05-18 |
| 1306059480 | David Roger Clark | Ophthalmology | 2812 Millbrook Ct, Arlington, TX 76012-2116 | 2007-05-07 |
| 1619049327 | David B Clark | Chiropractor | 106 Se 12th St, Oak Grove, MO 64075-9538 | 2006-11-15 |
| Street Address |
2101 ELM ST N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437143427 | Adam John Glazier | Internal Medicine | 2101 Elm St N, Fargo, ND 58102-2417 | 2005-09-06 |
| 1235740705 | Macy Jane Schindler | Occupational Therapist | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-08-10 |
| 1497363154 | Isaac Nies | Pharmacist | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-07-20 |
| 1376151597 | Paul Afanasi Polanski | Social Worker | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-07-14 |
| 1144848763 | Alexis Kokett | Pharmacist | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-07-09 |
| 1598396459 | Leah Roethel | Dietitian, Registered | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-01-30 |
| 1619508678 | Allison Wanner | Dietitian, Registered | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-01-29 |
| 1720622822 | Nicole Marie Justice | Psychologist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-10-31 |
| 1750923033 | Samantha J. Tupy | Psychologist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-10-08 |
| 1639723232 | Madelyn Provost | Pharmacist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801440532 | Nicole Berend | Pharmacist | 4476 31st Ave S Ste 105, Fargo, ND 58104-4532 | 2019-07-31 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1578081600 | Mary Faure | Pharmacist | 2400 32nd Ave S Ste 4, Fargo, ND 58103-5800 | 2017-09-09 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1528509189 | Mikhail Elias | Pharmacist | 1613 36 1/2 Ave S, Fargo, ND 58104-6101 | 2017-03-15 |
| 1326589250 | Virginia Howe | Pharmacist | 5180 Prosperity Way S Ste 106, Fargo, ND 58104-7568 | 2017-03-11 |
| 1245789072 | Hannah Surma | Pharmacist | 801 Broadway N # 204, Fargo, ND 58102-3641 | 2016-09-21 |
| 1720430564 | Tara Michelle Dammer | Pharmacist | 706 38th St N Ste A, Fargo, ND 58102-2953 | 2016-07-05 |
| 1235502220 | Alysia Honzay | Pharmacist | 234 Prairiewood Dr S, Fargo, ND 58103-4613 | 2015-11-12 |
| 1114300662 | Adam Parker Stubson | Pharmacist | 3175 25th St S Ste D, Fargo, ND 58103-6171 | 2015-07-01 |
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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.