MRS. VICKI LYNN CLARK (NPI# 1649415209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649415209 |
| Entity Type | Individual |
| Full Name | MRS. VICKI LYNN CLARK |
| Other Name | MRS. VICKI LYNN CLARK |
| Credential | RN, LSW |
| Practice Address |
13111 Westbrook Rd Brookville OH 45309-8732 |
| Practice Telephone | 9378334388 |
| Mailing Telephone | 9378334388 |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2018-01-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | S 0028386 | OH | Behavioral Health & Social Service Providers |
| N | 163W00000X | Registered Nurse | RN 185313 | OH | Nursing Service Providers |
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972990349 | Vicki Clark | Specialist | 13 Park Lawn Dr, Bethel, CT 06801-1043 | 2015-04-23 |
| 1972921468 | Vicki Marie Clark | Registered Nurse | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2014-04-01 |
| 1992145106 | Vicki L. Clark | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905-0001 | 2013-07-02 |
| 1770603268 | Vicki L Clark | Occupational Therapy Assistant | 36 Clinton St, Concord, NH 03301-2359 | 2007-03-30 |
| 1184790859 | Vicki Lyne Clark | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2006-11-27 |
| 1215041249 | Vicki Lynn Clark | Social Worker | 601 Highway 6 W, Iowa City, IA 52246-2209 | 2006-08-18 |
| 1699704114 | Vicki Hugh Clark | Dietitian, Registered | 274 E Chicago St, Coldwater, MI 49036-2041 | 2006-06-30 |
| 1578539094 | Vicki L Clark | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2006-02-24 |
| 1609878800 | Vicki E Clark | Nurse Practitioner | 460 Country Club Rd, Lumberton, NC 28360-9494 | 2005-06-01 |
| Street Address |
13111 WESTBROOK RD |
| City | BROOKVILLE |
| State | OH |
| Zip Code | 45309-8732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336603802 | Leigh Anne Malott | Physical Medicine & Rehabilitation | 425 Lauracella Ct, Englewood, OH 45309 | 2019-01-29 |
| 1801302260 | Karen Lynne Brooks | Technician | 4807-b Tennessee Street, South Charleston, WV 45309 | 2017-12-21 |
| 1447784582 | Cara Marie Wampler | Optometrist | 430 Arlington Rd Ste B, Brookville, OH 45309 | 2017-04-15 |
| 1093141368 | Stephanie E Prechtel | Specialist/Technologist | 752 Meadow Glen Ave, Brookville, OH 45309 | 2013-09-18 |
| 1316939523 | City of Brookville | Ambulance | 775 E Upper Lewisburg Salem Rd, Brookville, OH 45309-0001 | 2005-08-16 |
| 1508861006 | James A Dickey | Optometrist | 430 Arlington Rd, Suite B, Brookville, OH 45309-1103 | 2005-06-20 |
| 1912411497 | Eyedocs Family Eye Care | Optometrist | 430 Arlington Rd Ste B, Brookville, OH 45309-1103 | 2017-11-20 |
| 1124476411 | Kyle Maxam | Optometrist | 430 Arlington Rd, Brookville, OH 45309-1103 | 2016-05-27 |
| 1891895942 | Ohio Cvs Stores, L.L.C. | Durable Medical Equipment & Medical Supplies | 430 Arlington Rd, Brookville, OH 45309-1103 | 2006-09-25 |
| 1831108299 | Scott L Hora Od LLC | Optometrist | 430 Arlington Rd, Ste B, Brookville, OH 45309-1103 | 2006-08-05 |
| Find all providers in zip 45309 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497888 | Kelly Nichole Mcintyre | Case Manager/Care Coordinator | 328 S Stadium Dr, Xenia, OH 45385-2161 | 2020-11-05 |
| 1285235580 | Andrea Temeka Hill | Case Manager/Care Coordinator | Boundless Behavioral Health, Worthington, OH 43085-3183 | 2020-11-03 |
| 1114528775 | Trinka Louise Glenn | Case Manager/Care Coordinator | 6400 E Broad St # F14, Columbus, OH 43213-2086 | 2020-11-02 |
| 1457951097 | James P Watkins Jr. | Case Manager/Care Coordinator | 955 Snowfall Spur Apt B, Akron, OH 44313-4966 | 2020-10-30 |
| 1548860588 | Corey Allison | Case Manager/Care Coordinator | 312 Glenmore Ave. Ste 14, Cincinnati, OH 45238 | 2020-10-29 |
| 1871193706 | Brooke Siggers | Case Manager/Care Coordinator | 829 S Gettysburg Ave # 45416, Dayton, OH 45417-3569 | 2020-10-29 |
| 1164022182 | George Atta Owusu | Case Manager/Care Coordinator | 407 Lemery Dr, Columbus, OH 43213-4482 | 2020-10-28 |
| 1669072815 | Brandon Thomas | Case Manager/Care Coordinator | 111 S Byrne Rd, Toledo, OH 43615-6212 | 2020-10-27 |
| 1497355952 | Allen Richardson | Case Manager/Care Coordinator | 3450 W. Central Ave., Ste 366e, Toledo, OH 43606-1416 | 2020-10-26 |
| 1780284216 | April Lee | Case Manager/Care Coordinator | 900 W South Boundary St Bldg 6, Perrysburg, OH 43551-5235 | 2020-10-26 |
| Find all providers with the same taxonomy | ||||
| City | BROOKVILLE |
| Zip Code | 45309 |
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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.