SAMANTHA CLARK (NPI# 1710593462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710593462 |
| Entity Type | Individual |
| Full Name | SAMANTHA CLARK |
| Practice Address |
182 Chickasaw Trl Pontotoc MS 38863-8857 |
| Practice Telephone | 6628321832 |
| Mailing Telephone | 6628321832 |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285268177 | Samantha Fay Clark | Behavior Technician | 990d Klamath Ln, Yuba City, CA 95993-8961 | 2020-02-28 |
| 1225525298 | Samantha R Clark | Case Manager/Care Coordinator | Juneau County Dept. of Human Services, 200 Hickory Street, Mauston, WI 53948-2101 | 2018-04-16 |
| 1699186841 | Samantha Clark | Obstetrics & Gynecology | 224 W Exchange St Ste 420, Akron, OH 44302-1718 | 2014-05-09 |
| 1225636442 | Samantha Clark | Pharmacist | 3914 Capital Blvd, Raleigh, NC 27604-3412 | 2020-10-09 |
| 1902430630 | Samantha Clark | Behavior Technician | 1620 N Main St Ste 1, Walnut Creek, CA 94596-4653 | 2020-03-03 |
| 1366081036 | Samantha Clark | Case Manager/Care Coordinator | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2019-12-30 |
| 1144869900 | Samantha Jane Clark | Pharmacist | 330 Pine Tree Rd, Ithaca, NY 14850-2819 | 2019-12-26 |
| 1548816630 | Samantha Clark | Occupational Therapist | 1797 King Ave, Kings Mills, OH 45034-1721 | 2019-08-14 |
| 1871154443 | Samantha Jeanine Clark | Marriage & Family Therapist | 2621 Oswell St Ste 119, Bakersfield, CA 93306-3172 | 2019-06-25 |
| 1902460710 | Samantha Leigh Clark | Specialist | 9 Vose Farm Rd Ste 120, Peterborough, NH 03458-2154 | 2019-04-26 |
| Street Address |
182 CHICKASAW TRL |
| City | PONTOTOC |
| State | MS |
| Zip Code | 38863-8857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003429176 | Erik Goodwin | Chiropractor | 1 Goodwin Drive, Pontotoc, MS 38863 | 2020-08-28 |
| 1003455379 | Billie Jay Holloway | Technician | 1357 Hwy 9 South, Pontotoc, MS 38863 | 2020-01-03 |
| 1689185597 | Southern Physical and Aquatic Therapy, P.a. | Clinic/Center | 369 Peoples Drive, Pontotoc, MS 38863 | 2017-10-18 |
| 1699290460 | Jamie Michelle Holloway | Nurse Practitioner | 1374 Cooke Road, Pontotoc, MS 38863 | 2017-08-13 |
| 1235673351 | Carla Chism | Speech-Language Pathologist | 2564 Highway 345, Pontotoc, MS 38863 | 2016-12-08 |
| 1669924379 | Stephanie N Watson | Nurse Practitioner | 351 Peoples Dr. # A, Pontotoc, MS 38863 | 2016-10-28 |
| 1003285461 | Timothy R Watson | Nurse Practitioner | Acute Care and Family Clininc 351 Peoples Dr, 351 Peoples Dr, Pontotoc, MS 38863 | 2015-09-16 |
| 1770995938 | Mississippi Professional Counseling Associates | Social Worker | 356a East Oxford Street, Pontotoc, MS 38863 | 2014-05-22 |
| 1376852525 | Kenneth E Prewett | Pharmacist | 170 Highway 15 N, Pontotoc, MS 38863 | 2010-10-05 |
| 1801105051 | Thomas Keith Guntharp | Pharmacist | 170 Highway 15 North, Pontotoc, MS 38863 | 2010-10-05 |
| Find all providers in zip 38863 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442746 | Breanna Renee Bray | Student in an Organized Health Care Education/Training Program | 392 Pineridge Dr, Pontotoc, MS 38863-3706 | 2020-09-21 |
| 1003471699 | Katelyn Mitchell | Student in an Organized Health Care Education/Training Program | 192 Forest Dr, Pontotoc, MS 38863-1541 | 2019-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265049928 | Jillian Christina Smith | Student in an Organized Health Care Education/Training Program | 91570 Highway 42, Richton, MS 39476-9708 | 2020-09-28 |
| 1487261087 | William Andrew Harrelson | Student in an Organized Health Care Education/Training Program | 215 Union Line Rd, Laurel, MS 39443-0772 | 2020-09-28 |
| 1114534922 | Brianna Danielle Morris | Student in an Organized Health Care Education/Training Program | 415 Gatewood Dr, Pearl, MS 39208-4409 | 2020-09-25 |
| 1942817838 | Ebony Symone' Woodson | Student in an Organized Health Care Education/Training Program | 288 Mount Helm Rd, Brandon, MS 39047-8462 | 2020-09-25 |
| 1093322885 | Danna Shaye Jackson | Student in an Organized Health Care Education/Training Program | 115 Howard Heights Rd, Poplarville, MS 39470-7454 | 2020-09-25 |
| 1972110963 | Akira Keyana Baker | Student in an Organized Health Care Education/Training Program | 415 N Ione St, Tupelo, MS 38801-3116 | 2020-09-24 |
| 1043827900 | Carla Odom | Student in an Organized Health Care Education/Training Program | 963 Taylor Rd, Kokomo, MS 39643-4967 | 2020-09-24 |
| 1902413974 | Katharine Bogard | Student in an Organized Health Care Education/Training Program | 2032 Tuilleries Cv, Biloxi, MS 39531-2423 | 2020-09-24 |
| 1023624137 | Daysi Lisett Zanzon | Student in an Organized Health Care Education/Training Program | 210 S Lowe St, Hazlehurst, MS 39083-3017 | 2020-09-23 |
| 1922614171 | Kathleen Michele Tate | Student in an Organized Health Care Education/Training Program | 2412 Meadow Oak, Flowood, MS 39232-8780 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SAMANTHA 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.