MS. JOAN MARIE CLARK (NPI# 1710969498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710969498 |
| Entity Type | Individual |
| Full Name | MS. JOAN MARIE CLARK |
| Credential | ANP |
| Practice Address |
6400 Clayton Rd Ste 302 Saint Louis MO 63117-1850 |
| Mailing Address |
Po Box 955534 Saint Louis MO 63195-1019 |
| Practice Telephone | 3146453370 |
| Practice Fax Number | 3146450576 |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2020-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2816742621 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | EXCLUSIVE CHOICE | 060065 | 01 |
| PROVIDER NUMBER | 072280 | 01 | |
| MO | HEALTHLINK | 534842 | 01 |
| MO | BLUE CHOICE | 213137 | 01 |
| MO | RAILROAD MEDICARE | 500005275 | 01 |
| MO | 428933303 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083186209 | Joan Leslie Clark | Speech-Language Pathologist | 3898 Via Poinciana Ste 17, Lake Worth, FL 33467-2951 | 2018-12-28 |
| 1174776694 | Joan Macfarlane Clark | Social Worker | 607 Oak Ridge Dr, Boerne, TX 78006-8229 | 2008-10-28 |
| 1952476038 | Joan H Clark | Registered Nurse | Pds 1725 W 17th St, Santa Ana, CA 92706 | 2006-11-22 |
| 1790786176 | Joan M Clark | Physical Therapist | 285 Jefferson Dr W, Palmyra, VA 22963-2404 | 2005-08-09 |
| 1801379532 | Joan Clark | Speech-Language Pathologist | 3427 Chapel Rd, Hamilton, OH 45013-9292 | 2018-09-10 |
| 1013221639 | Joan Carol Clark | Speech-Language Pathologist | 3207 Rosemont Dr, Chattanooga, TN 37411-4219 | 2010-08-06 |
| 1336468263 | Joan Gary Clark | Counselor | 100 Se Whitener Rd, Shelton, WA 98584-7747 | 2010-05-17 |
| 1801936919 | Joan Kay Clark | Specialist/Technologist | 1095 Pingree Rd, Suite 119, Crystal Lake, IL 60014-1725 | 2007-02-07 |
| 1548316748 | Joan Kutner Clark | Social Worker | 223 Maison Dr Unit 28, Suite A-1, Myrtle Beach, SC 29572-5170 | 2007-01-28 |
| 1174696082 | Joan Carmack Clark | Nurse Practitioner | 2071 Herndon Ave, Clovis, CA 93611-6101 | 2006-11-16 |
| Street Address |
6400 CLAYTON RD STE 302 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63117-1850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619285 | Jennifer Lee Speiser | Nurse Practitioner | 12545 Olive Blvd, Saint Louis, MO 63141-6311 | 2020-11-04 |
| 1265045264 | Andrea Jane Montgomery | Nurse Practitioner | 444 Honeysuckle Ln, Saint Louis, MO 63119-4521 | 2020-08-28 |
| 1396362224 | Erin M Kehoe | Nurse Practitioner | 12973 Olive Blvd, Saint Louis, MO 63141-6149 | 2020-06-26 |
| 1508482506 | Matthew Dale Tieskoetter | Nurse Practitioner | 333 S Kirkwood Rd Ste 203, Saint Louis, MO 63122-6161 | 2020-06-25 |
| 1861033615 | Benedicta Esi | Nurse Practitioner | 6024 Pennsylvania Ave, Saint Louis, MO 63111-2555 | 2019-10-02 |
| 1245896893 | Katina D Smith | Nurse Practitioner | 8820 Mcnulty Dr, Saint Louis, MO 63114-4146 | 2019-05-18 |
| 1912413584 | Lucija Kozul Sadl | Nurse Practitioner | 3525 Forest Dale Dr, Saint Louis, MO 63125-4212 | 2017-12-19 |
| 1275071326 | Kathryn Ries | Nurse Practitioner | 3535 South Broadway, Suite 118, Saint Louis, MO 63118-3907 | 2017-02-09 |
| 1144775966 | Hienok Hailu | Nurse Practitioner | 11725 Casa Grande Dr, Saint Louis, MO 63146-4223 | 2016-08-22 |
| 1992167522 | Lanyn Clark | Nurse Practitioner | 40 Ladue Ter, Saint Louis, MO 63124-2048 | 2016-03-23 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63117 |
Please comment or provide details below to improve the information on MS. JOAN MARIE 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.