GREGORY P CLARK (NPI# 1730170796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730170796 |
| Entity Type | Individual |
| Full Name | GREGORY P CLARK |
| Credential | P.A. |
| Practice Address |
777 Avenue H Powell Valley Healthcare Inc Powell WY 82435 |
| Mailing Address |
777 Avenue H Powell WY 82435 |
| Practice Telephone | 3077543405 |
| Practice Fax Number | 3077541207 |
| Mailing Telephone | 3077543405 |
| Mailing Fax Number | 3077541207 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2015-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 203 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 115812100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760991012 | Gregory Clark | Driver | 1091 Old South Dr, Lakeland, FL 33811 | 2017-09-28 |
| 1184758229 | Gregory Ray Clark | Physical Therapist | 3 Windsor Ct, Shawnee, OK 74804-2330 | 2007-03-14 |
| 1114064797 | Gregory Dale Clark | Dentist | 4212 Mcever Rd, Oakwood, GA 30566-2237 | 2007-01-31 |
| 1225141823 | Gregory Lynn Clark | Specialist | 11790 Sw Barnes Rd, Suite 330, Portland, OR 97225-5934 | 2006-08-16 |
| 1689608952 | Gregory D Clark | Social Worker | 118 Broadway N, Ste 810, Fargo, ND 58102-4949 | 2006-07-10 |
| 1164409728 | Gregory Clark | Counselor | 225 N Beaumont Rd, Prairie Du Chien, WI 53821-1445 | 2005-12-26 |
| 1528627833 | Gregory Scott Clark | Nurse Anesthetist, Certified Registered | 3333 W Deyoung St, Marion, IL 62959-5884 | 2019-06-10 |
| 1073178851 | Gregory Clark | Student in an Organized Health Care Education/Training Program | 550 1st Ave, New York, NY 10016-6402 | 2019-05-07 |
| 1548736622 | Gregory Allen Clark | Marriage & Family Therapist | 1150 5th St Ste 270, Coralville, IA 52241-2933 | 2018-10-16 |
| 1881055911 | Gregory Scott Clark Jr. | Counselor | 1121 E Southeast Loop 323 Ste 204, Tyler, TX 75701 | 2016-03-17 |
| Street Address |
777 AVENUE H POWELL VALLEY HEALTHCARE INC |
| City | POWELL |
| State | WY |
| Zip Code | 82435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114923463 | Duncan Hugh Fraser | Podiatrist | 777 Avenue H, Powell, WY 82435-2260 | 2005-06-22 |
| 1639782790 | Nicolle Rae Cruz | Pharmacist | 777 Avenue H, Powell, WY 82435-2260 | 2020-08-28 |
| 1043843485 | Jessica Lee Mathews | Emergency Medical Technician, Paramedic | 777 Avenue H, Powell, WY 82435-2260 | 2020-02-13 |
| 1073150926 | Mary Neal | Dietitian, Registered | 777 Avenue H, Powell, WY 82435-2260 | 2019-12-10 |
| 1609418334 | Randall Keith Baxter | Nurse Practitioner | 777 Avenue H, Powell, WY 82435-2260 | 2019-10-15 |
| 1508329582 | Ashley Dee Engesser | Advanced Practice Midwife | 777 Avenue H, Powell, WY 82435-2260 | 2019-04-08 |
| 1780149948 | Bryan Kenneth Tipton | Physician Assistant | 777 Avenue H, Powell, WY 82435-2260 | 2019-02-01 |
| 1811460397 | Katherine Lindsey Swope | Speech-Language Pathologist | 777 Avenue H, Powell, WY 82435-2260 | 2019-01-07 |
| 1629571963 | Big Horn Ankle & Foot LLC | Durable Medical Equipment & Medical Supplies | 777 Avenue H, Powell, WY 82435-2260 | 2018-03-13 |
| 1538687652 | Amanda Bisby | Nurse Practitioner | 777 Avenue H, Powell, WY 82435-2260 | 2017-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841762648 | Cynthia Jean Garhart | Counselor | 235 East 2nd Street, Powell, WY 82435 | 2018-12-19 |
| 1982114138 | Peggy Ruth Cheatham | Case Manager/Care Coordinator | 317 S Day St, Powell, WY 82435 | 2017-10-02 |
| 1669921532 | Heavens Peak Behavioral Health Services, Ins | Clinic/Center | 64 Safe Haven Rd, Powell, WY 82435 | 2016-10-03 |
| 1730636895 | Kara Baus | Registered Nurse | 112 Safe Haven Road, Powell, WY 82435 | 2016-09-07 |
| 1942620208 | Susan C Hawkinson | Speech-Language Pathologist | 558 E 2nd St., Children's Resource Center Attention: Ila Jean Jenkins, Powell, WY 82435 | 2014-04-24 |
| 1376963801 | Shelby Marie Frost | Nurse Practitioner | 246 N Absaroka St, Powell, WY 82435 | 2014-04-23 |
| 1578993549 | Doni Lauk | Case Management | 458 S Ferris St, Powell, WY 82435 | 2013-11-12 |
| 1144579731 | Move On Physical Therapy, Inc. | Physical Therapist | 1201 E. 7th Street, Powell, WY 82435 | 2012-08-29 |
| 1992008841 | Justin Dean Mccoll | Counselor | 89 Rd 8 Ra, Powell, WY 82435 | 2010-12-15 |
| 1588977250 | James Lloyd | Obstetrics & Gynecology | 777 Ave H., Powell Valley Healthcare, Powell, WY 82435 | 2010-07-22 |
| Find all providers in zip 82435 | ||||
| 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 |
|---|---|---|---|---|
| 1467834838 | Robert Stephen Edmonds | Physician Assistant | 7540 Lancashire Blvd, Powell, TN 37849-3784 | 2015-06-22 |
| 1275721193 | Roxanne Kay Herman | Physician Assistant | 231 W 6th St, Powell, WY 82435-1898 | 2007-10-04 |
| 1629260542 | Frances L Do | Physician Assistant | 7557 Dannaher Dr., Tennessee Urology Associates, Powell, TN 37849 | 2007-08-14 |
| 1144704289 | Joseph Davidson | Physician Assistant | 128 N Bent St, Powell, WY 82435-2712 | 2018-09-24 |
| 1578073219 | Ashley Lynn Shehane | Physician Assistant | 7545 Barnett Way, Powell, TN 37849-3565 | 2017-10-09 |
| 1952751075 | Amy Buck | Physician Assistant | 777 Avenue H, Powell, WY 82435-2260 | 2016-06-20 |
| 1063870616 | Brett Garvey | Physician Assistant | 234 E Emory Rd, Powell, TN 37849-4015 | 2016-02-10 |
| 1306236534 | Tennessee Em-i Medical Services PC | Physician Assistant | 7565 Dannaher Dr, Powell, TN 37849-4029 | 2015-01-26 |
| 1851662498 | Lauren L. Clear | Physician Assistant | 7714 Conner Rd Ste 103, Powell, TN 37849-3559 | 2012-01-12 |
| 1821372061 | Sara Ruth Hughes | Physician Assistant | 201 E Emory Rd, Powell, TN 37849 | 2011-10-06 |
| Find all providers in POWELL | ||||
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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.