DR. THOMAS RANDALL CLARK (NPI# 1700833266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700833266 |
| Entity Type | Individual |
| Full Name | DR. THOMAS RANDALL CLARK |
| Credential | PH.D. |
| Practice Address |
2116 4th Ave Nw Minot ND 58703-2967 |
| Practice Telephone | 7018382442 |
| Practice Fax Number | 7018391193 |
| Mailing Telephone | 7018382442 |
| Mailing Fax Number | 7018391193 |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
ND238 | ND | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | BLUE CROSS BLUE SHIELD | 11725 | 01 |
| ND | 17462 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669096020 | Thomas Edward Clark | Optometrist | 3672 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7172 | 2020-06-02 |
| 1861053811 | Thomas J Clark | Massage Therapist | 16615 North Rd Unit B, Bothell, WA 98012-5983 | 2019-06-20 |
| 1922417005 | Thomas Boyle Clark IIi | Pathology | 3619 Pacific Ave, Tacoma, WA 98418-7921 | 2014-08-04 |
| 1053558205 | Thomas Edward Clark | Student in an Organized Health Care Education/Training Program | 980 Western Avenue, Albany, NY 12202 | 2009-01-09 |
| 1255593273 | Thomas James Clark | Licensed Practical Nurse | 8703 Shear Dr, Powell, OH 43065-8835 | 2008-06-30 |
| 1508044181 | Thomas B Clark | Chiropractor | 2092 Casa De Vereda, Vista, CA 92084-4223 | 2008-02-05 |
| 1306061502 | Thomas Lyon Clark | Psychologist | 1515 Payne St, Tallahassee, FL 32303-5796 | 2007-04-16 |
| 1487877213 | Thomas R Clark | Chiropractor | 2418 W 9th Ave, Amarillo, TX 79106-6620 | 2007-04-10 |
| 1023157153 | Thomas Clark | Dentist | 4402 Airline Dr, Houston, TX 77022-2934 | 2007-02-05 |
| 1972649499 | Thomas Colin Clark | Physical Therapist | 7111 E 21st St N Ste 103, Wichita, KS 67206 | 2007-01-30 |
| Street Address |
2116 4TH AVE NW |
| City | MINOT |
| State | ND |
| Zip Code | 58703-2967 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376197673 | Kathryn Gallagher | Social Worker | Minot Air Force Base, Apo, AA 58703 | 2019-07-25 |
| 1720527120 | North Hill Pharmacy LLC | Pharmacy | 2111 Landmark Cir Nw Ste C, Minot, ND 58703 | 2017-02-17 |
| 1881138238 | Ashley A Beeter, Pmh-dnp | Nurse Practitioner | 24 North Main Street, Suite K, Minot, ND 58703 | 2016-12-05 |
| 1851768501 | Apex Chiropractic | Chiropractor | 1500 21st Ave Nw, Suite 105, Minot, ND 58703 | 2015-08-28 |
| 1033404546 | Kayla R Lambrecht | Physical Therapist | 2111 Landmark Cir Nw # B, Minot, ND 58703 | 2011-06-13 |
| 1265684062 | Minot Dentistry PC | Dentist | 600-22nd Ave Nw, Minot, ND 58703 | 2008-10-13 |
| 1073529350 | Orvin G. Lommen | Social Worker | #9 Cortland Drive, Minot, ND 58703 | 2006-07-31 |
| 1306872478 | James Christopher Everett | Chiropractor | 2217 16th Street Nw, Minot, ND 58703 | 2006-06-23 |
| 1760917975 | Derek Cluff | Dentist | 194 Missle Ave, Minot Afb, ND 58703 | 2017-04-25 |
| 1750701280 | Mary J Solberg | Social Worker | 1705 4th Ave Nw, Minot, ND 58703 | 2014-04-23 |
| Find all providers in zip 58703 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083710800 | Timothy Trell Eaton | Psychologist | 1705 4th Ave Nw, Minot, ND 58703-2912 | 2006-09-16 |
| 1205821527 | Stephan Podrygula | Psychologist | 600 22nd Ave Nw, Northland Professional Building, Minot, ND 58703-0986 | 2005-09-13 |
| 1174168496 | Lifesource of North Carolina | Psychologist | 600 Main St S, Minot, ND 58701-4499 | 2019-11-11 |
| 1861866287 | Mehring Psychological Services, Plc | Psychologist | 1705 4th Ave Nw, Minot, ND 58703-2912 | 2015-11-23 |
| 1619340247 | Deon B Mehring | Psychologist | 1705 4th Ave Nw, Minot, ND 58703-2912 | 2015-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013542182 | Nicola Ashton Herting | Psychologist | 100 4th St S Ste 302, Fargo, ND 58103-1937 | 2020-03-09 |
| 1295367449 | Winds of Change Counseling Services LLC | Psychologist | 30 7th St. W, Door A, Dickinson, ND 58601 | 2020-02-05 |
| 1922650753 | Kelly Reiner | Psychologist | 10 S River Rd, Fort Yates, ND 58538 | 2019-07-11 |
| 1023598083 | Devils Lake Psychological Services, Pllc | Psychologist | 224 4th St Nw Ste 7, Devils Lake, ND 58301-2960 | 2018-08-20 |
| 1740789684 | Jocelyn Soderstrom | Psychologist | 211 4th St Ne Ste 4, Devils Lake, ND 58301-2479 | 2018-02-06 |
| 1023550951 | Fiana England | Psychologist | 1401 13th Ave E., West Fargo, ND 58078-8029 | 2016-11-09 |
| 1932542180 | Lisa Gustafson | Psychologist | 200 E Main Ave, Suite 202, Bismarck, ND 58501-3857 | 2013-04-08 |
| 1669743977 | Scott Ressler | Psychologist | 3678 Taylor St S, Fargo, ND 58104-7588 | 2012-01-18 |
| 1992093660 | Nichole Parkhouse | Psychologist | 2100 S Columbia Rd Ste 202, Grand Forks, ND 58201-5895 | 2011-07-15 |
| 1679873525 | Jessica Ann Hurdelbrink Jones | Psychologist | 1126 Westrac Dr S, Fargo, ND 58103-2473 | 2010-10-26 |
| 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.