BEVERLY MARIE CLARK (NPI# 1649404625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649404625 |
| Entity Type | Individual |
| Full Name | BEVERLY MARIE CLARK |
| Other Name | BEVERLY WILSON |
| Credential | MD |
| Practice Address |
1004 E. Madison St Yates Center KS 66783-1314 |
| Mailing Address |
309 Sanders St Burlington KS 66839-2616 |
| Practice Telephone | 6206252312 |
| Practice Fax Number | 6206253560 |
| Mailing Telephone | 6203645395 |
| Mailing Fax Number | 6203648719 |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2016-04-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 04-34503 | KS | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 94-07126 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200969130C | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518337732 | Beverly Clark | Nurse Practitioner | 803 West Main Street, Mountain View, AR 72560 | 2015-09-30 |
| 1861742777 | Beverly Elaine Clark | Occupational Therapist | 10803 Par Lane, Wichita, KS 67212-5948 | 2012-09-18 |
| 1992707814 | Beverly A Clark | Pharmacist | 5021 Monck Ct, Wilmington, NC 28409-3173 | 2005-08-11 |
| 1033655675 | Beverly Clark | Technician, Other | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2017-01-06 |
| 1770583924 | Beverly Anne-marie Clark | Specialist | 321 Genesee St, Oneida, NY 13421 | 2005-07-29 |
| Street Address |
1004 E. MADISON ST |
| City | YATES CENTER |
| State | KS |
| Zip Code | 66783-1314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316039837 | Southeast Kansas Multi-county Health Dept. | Clinic/Center | 120 West Rutledge, Yates Center, KS 66783-1238 | 2006-09-29 |
| 1851390405 | Yates Center Pharmacy, Inc | Pharmacist | 122 W Rutledge St, Yates Center, KS 66783-1238 | 2005-07-16 |
| 1962506162 | Yates Center Drug Inc | Pharmacy | 122 W Rutledge St, Yates Center, KS 66783-1238 | 2006-09-11 |
| 1124095039 | Betty J Cantrell | Optometrist | 218 W Rutledge St, Suite 1, Yates Center, KS 66783-1240 | 2006-03-01 |
| 1053644583 | Woodson School District 366 | Local Education Agency (LEA) | 101 W Butler St, Yates Center, KS 66783-1259 | 2009-09-16 |
| 1679785547 | Grene Vision Group LLC | Ophthalmology | 115 W Butler St, Yates Center, KS 66783-1259 | 2007-05-04 |
| 1487647194 | Steven D Epler | Dentist | 109 W Butler St, Yates Center, KS 66783-1259 | 2005-08-27 |
| 1538558135 | Yates Center Dental LLC | Dentist | 109 W Butler St, Yates Center, KS 66783-1259 | 2015-01-20 |
| 1487658092 | John D Atkin | Family Medicine | 1004 E Madison St, Yates Center, KS 66783-1314 | 2005-06-10 |
| 1922246354 | Coffey County Hospital | Clinic/Center | 1004 E Madison St, Yates Center, KS 66783-1314 | 2009-01-22 |
| Find all providers in zip 66783 | ||||
| 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 |
|---|---|---|---|---|
| 1598370892 | River City Osteopathic Clinic | Family Medicine | 401 E 1st St, Wichita, KS 67202-2501 | 2020-09-14 |
| 1396357166 | Spira Care, LLC | Family Medicine | 7341 W 133rd St, Overland Park, KS 66213-4750 | 2020-08-21 |
| 1902428840 | County of Logan | Family Medicine | 1001 Highway 40 Ste 4, Oakley, KS 67748-6061 | 2020-05-14 |
| 1285253492 | Lawrence Physicians LLC | Family Medicine | 3211 S Iowa St Ste 100, Lawrence, KS 66046-5205 | 2020-04-09 |
| 1164052973 | Theory Health Kansas LLC | Family Medicine | 10000 Marshall Dr, Lenexa, KS 66215-1244 | 2020-01-21 |
| 1477108603 | Laurie Irene Haury | Family Medicine | 818 N Emporia St Ste 107, Wichita, KS 67214-3725 | 2019-08-05 |
| 1477107878 | Lawrence Physicians LLC | Family Medicine | 2001 Haskell Ave Ste A, Lawrence, KS 66046-3249 | 2019-07-25 |
| 1104484773 | Lawrence Physicians LLC | Family Medicine | 1130 W 4th St Ste 1015, Lawrence, KS 66044-1328 | 2019-05-30 |
| 1265900286 | Kansas Wellness Associates LLC | Family Medicine | 4300 W 133rd Street, Suite 200, Leawood, KS 66209 | 2018-11-07 |
| 1043794373 | Rajwinder Kaur | Family Medicine | 540 E Santa Fe St Ste E, Olathe, KS 66061-3400 | 2018-09-22 |
| Find all providers with the same taxonomy | ||||
| City | YATES CENTER |
| Zip Code | 66783 |
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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.