MRS. HEIDI LYNN CLARK (NPI# 1720154701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720154701 |
| Entity Type | Individual |
| Full Name | MRS. HEIDI LYNN CLARK |
| Credential | RD |
| Practice Address |
60 Mdg/mdts 101 Bodin Circle Travis Afb CA 94535-1809 |
| Practice Telephone | 7074233665 |
| Mailing Telephone | 7074233665 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2015-08-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255321386 | Heidi Marie Clark | Family Medicine | 10 Trieble Dr, Tunkhannock, PA 18657-7054 | 2005-10-28 |
| 1962821041 | Heidi Clark | Physical Therapist | 2455 Union Lake Rd, Commerce Twp, MI 48382-3596 | 2014-04-15 |
| 1649520560 | Heidi S Clark | Speech-Language Pathologist | 1000 E University Ave Dept 3311, Laramie, WY 82071-2001 | 2012-09-18 |
| 1730456427 | Heidi Clark | Acupuncturist | 4530 Sw Hall Blvd, Beaverton, OR 97005-0504 | 2011-11-23 |
| 1154614808 | Heidi C. Clark | Case Manager/Care Coordinator | 31912 Little Boston Rd Ne, Kingston, WA 98346-9700 | 2011-05-26 |
| 1487808028 | Heidi Lynn Clark | Speech-Language Pathologist | 1529 Nye Rd, Lyons, NY 14489-9111 | 2008-11-10 |
| 1992902282 | Heidi Marie Clark | Nurse Practitioner | 795 El Camino Real, Palo Alot, CA 94301-2203 | 2007-06-29 |
| 1740403542 | Heidi Ringgenberg Clark | Speech-Language Pathologist | 11688 Lake Forest Pkwy, Carmel, IN 46033-7208 | 2007-04-10 |
| 1124189196 | Heidi Clark | Nurse Practitioner | 111 Michigan Ave Nw, Washington, DC 20010-2916 | 2006-12-13 |
| Street Address |
60 MDG/MDTS 101 BODIN CIRCLE |
| City | TRAVIS AFB |
| State | CA |
| Zip Code | 94535-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861747586 | Sarah Celeste Fitch | Dietitian, Registered | 101 Bodin Circle 60 Mdg, Travis Afb, CA 94535-1800 | 2012-07-18 |
| 1356370068 | Linda Louise Cowling | Dietitian, Registered | 60 Mdts/sgqd, 101 Bodin Circle, Travis Afb, CA 94535-1800 | 2006-07-03 |
| 1093765257 | Lisa M Kovalek | Dietitian, Registered | 105 Bodin Cir, Travis Afb, CA 94535-1801 | 2006-05-10 |
| 1881683043 | Jennifer Bradley Harward | Dietitian, Registered | 60 Mdg/sgqd, 101 Bodin Circle, Travis Afb, CA 94535-1800 | 2005-10-19 |
| 1548820020 | Amanda Leal Diaz | Dietitian, Registered | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2019-06-18 |
| 1497253793 | Christi Triche | Dietitian, Registered | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2018-02-01 |
| 1669829370 | Mckinzie Alston | Dietitian, Registered | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2016-05-23 |
| 1356741755 | Linderpal Kaur Dhillon | Dietitian, Registered | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2014-09-04 |
| 1477730240 | Sara Elizabeth Koepke | Dietitian, Registered | 101 Bodin Circle, Travis Afb, CA 94535 | 2008-01-23 |
| 1265628390 | Craig Saewong | Dietitian, Registered | 60 Mdg/sgqd, 101 Bodin Cir, Travis Afb, CA 94535-1800 | 2007-09-21 |
| Find all providers in TRAVIS AFB | ||||
| City | TRAVIS AFB |
| Zip Code | 94535 |
Please comment or provide details below to improve the information on MRS. HEIDI LYNN 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.