GAYLE CHAPPELL CLARK (NPI# 1629263447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629263447 |
| Entity Type | Individual |
| Full Name | GAYLE CHAPPELL CLARK |
| Credential | R.PH |
| Practice Address |
10929 Us Highway 301 S Suite 111 Statesboro GA 30458-7774 |
| Practice Telephone | 9127647839 |
| Mailing Telephone | 9127647839 |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2011-08-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835G0303X |
Pharmacist Specialization: Geriatric |
14963 | GA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023173101 | Gayle K Clark | Social Worker | 2511 Oleander Dr, Durham, NC 27703-8188 | 2006-12-27 |
| 1679653570 | Gayle Clark | Pharmacy Technician | 815 E 6th Street, Tishomingo, OK 73460 | 2006-10-16 |
| 1407130123 | Gayle Ann Clark | Social Worker | 940 Belmont St, Brockton, MA 02301-5596 | 2011-09-29 |
| 1154561611 | Gayle Marie Clark | Social Worker | 100 Ledgewood Pl, Suite 202, Rockland, MA 02370-1075 | 2009-02-24 |
| Street Address |
10929 US HIGHWAY 301 S SUITE 111 |
| City | STATESBORO |
| State | GA |
| Zip Code | 30458-7774 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366637142 | Russell Jay Bozeman | Pharmacist | 10929 Us Highway 301 S, Suite 111, Statesboro, GA 30458-7774 | 2007-09-13 |
| 1417143181 | Donna Lisa Moxley Lassiter | Pharmacist | 10929 Us Highway 301 S, Suite 111, Statesboro, GA 30458-7774 | 2007-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642218 | Youtherapy | Counselor | 430 Northside Dr East, Suite 160 Mb326, Statesboro, GA 30458 | 2019-01-07 |
| 1053891853 | Alexandria Franklin | Specialist/Technologist | 1332 Southern Dr, Statesboro, GA 30458 | 2018-08-21 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1689186405 | Chandler James Herman | Specialist/Technologist | 590 Herty Dr., Statesboro, GA 30458 | 2017-11-02 |
| 1477009181 | Mama Doc Pediatrics, LLC | Pediatrics | 400 East Grady Street, Statesboro, GA 30458 | 2016-09-01 |
| 1053761171 | Rebekah Roessler | Specialist/Technologist | 2687 Akins Blvd, Statesboro, GA 30458 | 2016-06-20 |
| 1427412253 | Refocus Counseling and Consulting Services | Community/Behavioral Health | 4325 Country Club, 4, Statesboro, GA 30458 | 2016-04-07 |
| 1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
| 1760870398 | Jessica Pasternack | Specialist/Technologist | 2687 Akins Boulevard, Statesboro, GA 30458 | 2015-01-06 |
| 1922401629 | Nathan D'amico | Student in an Organized Health Care Education/Training Program | 15 W Grady Street Unit A, Statesboro, GA 30458 | 2014-10-08 |
| Find all providers in zip 30458 | ||||
| Taxonomy Code | 1835G0303X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Geriatric |
| A pharmacist who is certified in geriatric pharmacy practice is designated as a "Certified Geriatric Pharmacist" (CGP). To become certified, candidates are expected to be knowledgeable about principles of geriatric pharmacotherapy and the provision of pharmaceutical care to the elderly. |
| Notes: Source: Commission for Certification in Geriatric Pharmacy (www.ccgp.org) [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366637142 | Russell Jay Bozeman | Pharmacist | 10929 Us Highway 301 S, Suite 111, Statesboro, GA 30458-7774 | 2007-09-13 |
| 1417143181 | Donna Lisa Moxley Lassiter | Pharmacist | 10929 Us Highway 301 S, Suite 111, Statesboro, GA 30458-7774 | 2007-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124563325 | Joseph Edward Holt | Pharmacist | 1200 Hickory Dr, Valdosta, GA 31602-2711 | 2016-12-23 |
| 1184026064 | Candice Charles Dabbs | Pharmacist | 1485 Leverette Rd, Apartment 407, Warner Robins, GA 31088-6487 | 2014-09-22 |
| 1780922799 | Robert A Davis | Pharmacist | 500 Industrial Boulevard, Dublin, GA 31021 | 2013-01-25 |
| 1073850855 | Charles Cordaro | Pharmacist | 2000 East West Connector, Health Services Center, 1st Floor - Pharmacy, Austell, GA 30127 | 2013-01-14 |
| 1841544129 | Todd Woodard | Pharmacist | 1850 Cotillion Dr Apt 2114, Atlanta, GA 30338-7881 | 2012-11-07 |
| 1225387053 | Dennis Lester Trado | Pharmacist | 1415 Ashwood Dr, Evans, GA 30809 | 2012-09-07 |
| 1982989026 | Robert Randal Warnock | Pharmacist | 1060 Riverhill Dr, Bishop, GA 30621-6121 | 2011-10-20 |
| 1730461039 | Holly Spriggs Infante | Pharmacist | 103 Deer Valley Ln, Woodstock, GA 30189-2523 | 2011-09-13 |
| 1770881849 | James Wooten O'neal IIi | Pharmacist | 8 Surry Plaza, Hawkinsville, GA 31036 | 2011-03-14 |
| 1326283268 | Brian L Taffin | Pharmacist | 101 Silver Creek Dr, Canton, GA 30114-4213 | 2008-12-05 |
| Find all providers with the same taxonomy | ||||
| City | STATESBORO |
| Zip Code | 30458 |
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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.