CLARK CLINIC INC (NPI# 1639693492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639693492 |
| Entity Type | Organization |
| Organization Name | CLARK CLINIC INC |
| Practice Address |
910 W Myers Blvd Mascotte FL 34753-9748 |
| Mailing Address |
212 S Florida St Bushnell FL 33513-6703 |
| Practice Telephone | 3527871600 |
| Practice Fax Number | 3527933282 |
| Mailing Telephone | 3527932441 |
| Mailing Fax Number | 8664070034 |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2018-04-09 |
| Authorized Official Name | DR. LOWELL F CLARK (PRESIDENT) |
| Authorized Official Telephone | 3527932441 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013540947 | Clark Clinic Inc | Clinic/Center | 12620 Curley St, San Antonio, FL 33576-8136 | 2020-02-19 |
| 1467642942 | Clark Clinic Inc | Clinic/Center | 107 W Central Ave, Howey In The Hills, FL 34737-4302 | 2007-07-31 |
| 1992338156 | Clark Clinic Inc | Clinic/Center | 110 Lodge Terrace Dr, Altoona, FL 32702-9668 | 2020-02-17 |
| 1225661481 | Clark Clinic Inc | Clinic/Center | 31450 Church St, Sorrento, FL 32776-9594 | 2020-02-17 |
| 1376733857 | Clark Clinic Inc | Clinic/Center | 212 S Florida St, Bushnell, FL 33513-6703 | 2007-07-31 |
| Street Address |
910 W MYERS BLVD |
| City | MASCOTTE |
| State | FL |
| Zip Code | 34753-9748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336347426 | Takita's Helping Hand | Day Training, Developmentally Disabled Services | 255 Boca Ciega Rd, Mascotte, FL 34753 | 2007-07-10 |
| 1871070920 | Justo Nual Perez | Registered Nurse | 16 Lake Jackson Dr, Mascotte, FL 34753-8806 | 2018-07-22 |
| 1285863589 | Andrea Geraldine Delph | Occupational Therapist | 5136 Pine Needle Dr, Mascotte, FL 34753-8867 | 2009-07-08 |
| 1700134715 | Nabuchi Grace Anderson | Counselor | 15508 Willet Ct, Mascotte, FL 34753-9102 | 2012-08-22 |
| 1538614540 | Grace's Support Services, LLC | Case Manager/Care Coordinator | 15508 Willet Ct, Mascotte, FL 34753-9102 | 2016-08-19 |
| 1225401912 | Life Change Outreach Organization, Inc | Home Health | 15508 Willet Ct, Mascotte, FL 34753-9102 | 2015-11-04 |
| 1992057723 | Life Change Outreach Organization | Case Manager/Care Coordinator | 15508 Willet Ct, Mascotte, FL 34753-9102 | 2012-10-03 |
| 1114479367 | Jamie Small | Behavior Technician | 301 Boca Ciega Rd, Mascotte, FL 34753-9224 | 2016-11-03 |
| 1174825210 | Lazina Johannah Thomas | Case Manager/Care Coordinator | 315 Carol St, Mascotte, FL 34753-9253 | 2010-11-22 |
| 1982036133 | Life Change Outreach Organization, Inc | Home Health | 55 Bluff Lake Rd, Suite A, Mascotte, FL 34753-9501 | 2013-07-30 |
| Find all providers in zip 34753 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917015 | Bonifay Rural Health Cinic | Clinic/Center | 2910 Hospital Dr Ste A, Bonifay, FL 32425-4268 | 2020-09-23 |
| 1013540947 | Clark Clinic Inc | Clinic/Center | 12620 Curley St, San Antonio, FL 33576-8136 | 2020-02-19 |
| 1023506532 | Sacred Heart Hospital On The Gulf | Clinic/Center | 805 Highway 22, Wewahitchka, FL 32465-3237 | 2018-04-30 |
| 1194173419 | Holmes County Hospital Corporation | Clinic/Center | 5556 Brown St, Graceville, FL 32440-1007 | 2016-05-26 |
| 1568826873 | Healthvine Medical Group Inc | Clinic/Center | 725 Benton Ave, Brooksville, FL 34601-3213 | 2016-04-12 |
| 1164808465 | Family and After Hours Care, LLC | Clinic/Center | 1413 Nw 23rd Ave, Chiefland, FL 32626 | 2015-08-10 |
| 1891171914 | High Springs Pediatrics LLC. | Clinic/Center | 14900 Nw 140th St, Alachua, FL 32615-6276 | 2015-07-31 |
| 1982963344 | Sacred Heart Hospital On The Gulf | Clinic/Center | 55 Avenue 'e', Apalachicola, FL 32320-1763 | 2012-05-04 |
| 1760776900 | Sonnis Pediatrics, Inc. | Clinic/Center | 1125 S 6th Ave, Wauchula, FL 33873-3350 | 2011-06-06 |
| 1336454339 | West Florida Medical Associates, P. A | Clinic/Center | 4363 South Suncoast Blvd, Homosassa Springs, FL 34446 | 2010-08-13 |
| Find all providers with the same taxonomy | ||||
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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.