DR. AMY CHRISTINE CLARK (NPI# 1649595174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649595174 |
| Entity Type | Individual |
| Full Name | DR. AMY CHRISTINE CLARK |
| Other Name | MS. AMY CHRISTINE WILSON |
| Credential | DO |
| Practice Address |
155 Calle Portal Suite 300 Sierra Vista AZ 85635-2900 |
| Mailing Address |
1205 F Ave Douglas AZ 85607-1920 |
| Practice Telephone | 5204593011 |
| Practice Fax Number | 5203644261 |
| Mailing Telephone | 5203646852 |
| Mailing Fax Number | 5203644261 |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2017-06-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 006234 | AZ | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 006234 | AZ | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 20A12388 | CA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 5101018785 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 921693 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245640085 | Amy Clark | Nurse Practitioner | 1641 Highway 19e Byp, Elizabethton, TN 37643-4646 | 2014-05-01 |
| 1386988194 | Amy J. Clark | Registered Nurse | 731 18th Ave, San Francisco, CA 94121-3824 | 2012-11-16 |
| 1104121318 | Amy Beth Clark | Nurse Practitioner | 5197 Georgetown Rd, Franklin, PA 16323-4807 | 2011-01-19 |
| 1568766756 | Amy Sue Clark | Speech-Language Pathologist | 6 Erica Ct, Pueblo, CO 81001-1074 | 2011-01-02 |
| 1124328570 | Amy Leigh Clark | Social Worker | 1950 Trenton St, #412, Denver, CO 80220-2064 | 2010-11-01 |
| 1437461191 | Amy J Clark | Speech-Language Pathologist | 3609 Western Ave, Mattoon, IL 61938-2040 | 2010-07-10 |
| 1215257498 | Amy Clark | Occupational Therapy Assistant | 2770 Juniper Dr, Batesville, AR 72501-7801 | 2010-06-10 |
| 1881818656 | Amy Elizabeth Clark | Speech-Language Pathologist | 1027 Hiland St, Monticello, KY 42633-1370 | 2007-04-12 |
| 1023188018 | Amy Clark | Physical Therapist | 9381 East Stockton Blvd, Ste 108, Elk Grove, CA 95624 | 2006-11-08 |
| 1134236631 | Amy Clark | Physical Therapist | 506 Ne State Route 291, Lees Summit, MO 64086-2533 | 2006-08-23 |
| Street Address |
155 CALLE PORTAL SUITE 300 |
| City | SIERRA VISTA |
| State | AZ |
| Zip Code | 85635-2900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235103508 | Kathleen Jane Vedock | Pediatrics | 155 Calle Portal, Suite 700, Sierra Vista, AZ 85635-2900 | 2006-02-14 |
| 1205381472 | Lakeisha Love | Nurse Practitioner | 155 Calle Portal, Suite 300, Sierra Vista, AZ 85635-2900 | 2016-08-17 |
| 1710342043 | Kerstin P Hurley | Psychologist | 155 Calle Portal, Suite 300, Sierra Vista, AZ 85635-2900 | 2015-12-31 |
| 1316318728 | Kerstin P. Hurley, Phd | Psychologist | 155 Calle Portal, Suite 300, Sierra Vista, AZ 85635-2900 | 2015-10-12 |
| 1417331711 | Chiricahua Community Health Centers, Inc | Clinic/Center | 155 Calle Portal, Suite 300, Sierra Vista, AZ 85635-2900 | 2015-07-16 |
| 1033532163 | Akdhc, LLC | Internal Medicine | 155 Calle Portal, Suite 400, Sierra Vista, AZ 85635-2900 | 2014-01-24 |
| 1689925711 | Dean D Ettinger Md PC | Pediatrics | 155 Calle Portal, Suite 200, Sierra Vista, AZ 85635-2900 | 2012-09-28 |
| 1760781017 | Dixie Jean Millican | Nurse Practitioner | 155 Calle Portal, Suite 200, Sierra Vista, AZ 85635-2900 | 2011-03-24 |
| 1821309089 | Chiricahua Community Health Centers, Inc | Clinic/Center | 155 Calle Portal, Suite 700, Sierra Vista, AZ 85635-2900 | 2010-06-23 |
| 1790961167 | Carnett Clinic, LLC | Family Medicine | 155 Calle Portal, Suite 600, Sierra Vista, AZ 85635-2900 | 2008-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740640 | Taylor Anne Phelps | Student in an Organized Health Care Education/Training Program | Haven of Sierra Vista LLC, 660 Coronado Drive, Sierra Vista, AZ 85635 | 2020-05-06 |
| 1568001543 | Gp Medicine, Pllc | Family Medicine | 1800 E Wilcox Drive, Sierra Vista, AZ 85635 | 2019-12-23 |
| 1518515212 | Canyon Vista Dental | Dentist | 1993 S Frontage Road, Suite 208, Sierra Vista, AZ 85635 | 2019-08-27 |
| 1225697402 | Kristine Vincent Cruz Angeles | Dentist | 115 Calle Poral, Sierra Vista, AZ 85635 | 2019-06-11 |
| 1700397411 | Vivian Ryu | Social Worker | 2300 E Fry Blvd, #3822, Sierra Vista, AZ 85635 | 2017-10-20 |
| 1750806758 | Rosemary Nduta Kagwanja | Technician | 425 Bernini Avenue, N/a, Sierra Vista, AZ 85635 | 2017-08-10 |
| 1093245789 | Akdhc, LLC | Internal Medicine | 5555 Mesa Verde Dr, Suite 100, Sierra Vista, AZ 85635 | 2017-06-14 |
| 1609304633 | Vincent Guarino | Emergency Medicine | 5700 E, Az-90, Sierra Vista, AZ 85635 | 2017-06-04 |
| 1629506811 | Andrew Tang | Student in an Organized Health Care Education/Training Program | 5700 Arizona 90, Sierra Vista, AZ 85635 | 2017-06-01 |
| 1194259382 | Walik Hargett | Contractor | 800 N. Lenzner Ave Apt 776b, Sierra Vista, AZ 85635 | 2017-04-14 |
| Find all providers in zip 85635 | ||||
| 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 |
|---|---|---|---|---|
| 1447864830 | Prevencare Health Services, LLC | Family Medicine | 750 Bartow Dr Ste 16, Sierra Vista, AZ 85635-1833 | 2020-09-02 |
| 1942811997 | Raquiel Santos | Family Medicine | 4301 Plaza Vis Apt C, Sierra Vista, AZ 85635-4323 | 2020-08-13 |
| 1568001543 | Gp Medicine, Pllc | Family Medicine | 1800 E Wilcox Drive, Sierra Vista, AZ 85635 | 2019-12-23 |
| 1821541723 | Joseph Thompson | Family Medicine | 5700 Az 90, Sierra Vista, AZ 85635 | 2016-07-27 |
| 1821238171 | Ann Lebeck | Family Medicine | 3353 Canyon De Flores, Suite A, Sierra Vista, AZ 85650 | 2009-02-26 |
| 1073703310 | Jeffrey Virgil Wilde | Family Medicine | 2585 E Wilcox Dr Ste A, Sierra Vista, AZ 85635-2822 | 2007-08-01 |
| 1710025051 | Papago Medical, PC | Family Medicine | 1729 Paseo San Luis, Sierra Vista, AZ 85635-4611 | 2007-02-01 |
| 1356356067 | Louise Nosanchuck | Family Medicine | 77 E Fry Blvd, Sierra Vista, AZ 85635-1813 | 2006-07-30 |
| 1699796631 | Marc A Kaplan Pllc | Family Medicine | 2585 E Wilcox Dr Ste C, Sierra Vista, AZ 85635-2822 | 2006-07-23 |
| 1619918836 | Marc A Kaplan | Family Medicine | 2585 E Wilcox Dr., #c, Sierra Vista, AZ 85635 | 2006-06-09 |
| Find all providers in SIERRA VISTA | ||||
| City | SIERRA VISTA |
| Zip Code | 85635 |
Please comment or provide details below to improve the information on DR. AMY CHRISTINE CLARK.
| 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.