DOMINIQUE CLARK (NPI# 1700255726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700255726 |
Entity Type | Individual |
Full Name | DOMINIQUE CLARK |
Practice Address |
7474 Greenway Center Dr Ste 730 Greenbelt MD 20770-3523 |
Mailing Address |
7474 Greenway Center Dr Ste 700b Greenbelt MD 20770-3523 |
Practice Telephone | (301) 982-3437 |
Practice Fax Number | 3019829452 |
Mailing Telephone | 2402773359 |
Mailing Fax Number | 8452316078 |
Enumeration Date | 2015-09-21 |
Last Update Date | 2019-12-10 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | C0005875 | MD | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
174 Waterfront St, Oxon Hill, MD 207451154 | 3014857400 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609315910 | Dominique J Clark | Behavior Technician | 11216 108th Way, Largo, FL 33778-3320 | 2017-02-20 |
1265678502 | Dominique Jolie Clark | Speech-Language Pathologist | 12201 Wallace Landing Ct, Upper Marlboro, MD 20772-7957 | 2008-12-16 |
1578180345 | Dominique Lacee Clark | Social Worker | 26429 Michigan Ave, Inkster, MI 48141-2464 | 2020-06-28 |
1346874716 | Dominique Clark | Registered Nurse | 5180 Park Ave Ste 250, Memphis, TN 38119-3535 | 2020-02-25 |
Street Address |
7474 GREENWAY CENTER DR STE 730 |
City | GREENBELT |
State | MD |
Zip Code | 20770-3523 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154509123 | Jose Carlos Vera II | Social Worker | 7474 Greenway Center Dr Ste 730, Greenbelt, MD 20770-3523 | 2008-02-01 |
1336753029 | Alicia Dunwell | Counselor | 7474 Greenway Center Dr Ste 730, Greenbelt, MD 20770-3523 | 2020-09-01 |
1427675065 | Khameelah L Tomlin | Social Worker | 7474 Greenway Center Dr Ste 730, Greenbelt, MD 20770-3523 | 2020-06-30 |
1134762503 | Claudia M Sosa | Social Worker | 7474 Greenway Center Dr Ste 730, Greenbelt, MD 20770-3523 | 2019-10-17 |
1184266959 | Wendy Peal Grier | Social Worker | 7474 Greenway Center Dr Ste 730, Greenbelt, MD 20770-3523 | 2019-10-14 |
1891336012 | Jasmine Marie Smith | Counselor | 7474 Greenway Center Dr Ste 730, Greenbelt, MD 20770-3523 | 2019-09-30 |
1639729361 | Bryce Douglas Clyburne | Social Worker | 7474 Greenway Center Dr Ste 730, Greenbelt, MD 20770-3523 | 2019-09-15 |
1508412438 | Michellee Alicia Jones | Social Worker | 7474 Greenway Center Dr Ste 730, Greenbelt, MD 20770-3523 | 2019-08-15 |
1417500752 | Katelyn Sun | Student in an Organized Health Care Education/Training Program | 7474 Greenway Center Dr Ste 730, Greenbelt, MD 20770-3523 | 2019-07-16 |
1295387033 | Ada Gabriela Canelas | Social Worker | 7474 Greenway Center Dr Ste 730, Greenbelt, MD 20770-3523 | 2019-07-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841805405 | Caring Hands Medical Clinic LLC | Nurse Practitioner | 7201 Handover Parkway, Suite B, Greenbelt, MD 20770 | 2020-09-10 |
1770107203 | Jeannette Nicole Welds | Social Worker | 7710-303 Hanover Parkway, Greenbelt, MD 20770 | 2020-06-01 |
1063032597 | Victory Clinical Research | Specialist | 7212 Hanover Parkway, Suite A, Greenbelt, MD 20770 | 2020-04-24 |
1336793884 | Yan Chen | Physician Assistant | 7300 Hanover Drive, Suite 104, Greenbelt, MD 20770 | 2019-08-01 |
1245884519 | Antonio Moody | Counselor | 7474 Greenbelt Center Drive, Greenbelt, MD 20770 | 2019-07-25 |
1881166494 | Jeniece Edwina Weddington | Speech-Language Pathologist | Eleanor Roosevelt High School- Pgcps, 7601 Hanover Parkway, Greenbelt, MD 20770 | 2018-12-20 |
1043797996 | Thomas Mesumbe | Home Health Aide | 6204 Sringhill Drive, Apartment 201, Greenbelt, MD 20770 | 2018-07-24 |
1063914554 | Zainab Anita Foday | Home Health Aide | 5923 Cherrywood Terrace Apt 101, Greenbelt, MD 20770 | 2018-03-01 |
1619479193 | Nancy Benga | Home Health Aide | 5821 Cherrywood Ln Apt 104 5821 Cherry Wood Ln Apt 104, Greenbelt, MD 20770 | 2018-03-01 |
1912407891 | Adoni Healthcare Services, LLC | Clinic/Center | 7525 Greenway Center Dr Ste 316, Greenbelt, MD 20770 | 2018-02-16 |
Find all providers in zip 20770 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285252015 | Neha Shrestha | Physician Assistant | 7806 Somerset Ct, Greenbelt, MD 20770-3022 | 2020-07-08 |
1336793884 | Yan Chen | Physician Assistant | 7300 Hanover Drive, Suite 104, Greenbelt, MD 20770 | 2019-08-01 |
1396286902 | Kelsey Noel Ortbahn | Physician Assistant | 7501 Greenway Center Dr Ste 620, Greenbelt, MD 20770-6702 | 2017-03-15 |
1720471725 | Kerin Lynn Hamilton | Physician Assistant | 7474 Greenway Center Dr Ste 700a, Greenbelt, MD 20770-3523 | 2015-03-15 |
1073178919 | Gbessay Nyallay Ngombi | Physician Assistant | 7225 Hanover Pkwy, Greenbelt, MD 20770-2024 | 2019-05-06 |
1629519574 | Richard Kennedy | Physician Assistant | 7300 Hanover Dr Ste 104, Greenbelt, MD 20770-2250 | 2017-03-12 |
1518352251 | Sarah Mubeen Syeda | Physician Assistant | 7501 Greenway Center Dr, Suite 660, Greenbelt, MD 20770-3514 | 2015-03-31 |
1972928620 | Helen Chemere | Physician Assistant | 7501 Greenway Center Dr, Suite 730, Greenbelt, MD 20770-3514 | 2014-03-04 |
1043656309 | Katherine Durland Lyons | Physician Assistant | 7300 Hanover Dr Ste 104, Greenbelt, MD 20770-2250 | 2013-05-14 |
1053522813 | Allison Wagner Scaduto | Physician Assistant | 7701 Greenbelt Rd, Suite 504, Greenbelt, MD 20770-2037 | 2007-05-24 |
Find all providers in GREENBELT |
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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.