MR. COLIE BOB CLARK JR. (NPI# 1740452218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740452218 |
| Entity Type | Individual |
| Full Name | MR. COLIE BOB CLARK JR. |
| Credential | BS, CCP, LP |
| Practice Address |
3101 Carriage Trl Hillsborough NC 27278-8508 |
| Practice Telephone | 9198803688 |
| Mailing Telephone | 9198803688 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 242T00000X | Perfusionist | NC | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
3101 CARRIAGE TRL |
| City | HILLSBOROUGH |
| State | NC |
| Zip Code | 27278-8508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710504600 | Drs. Latta & Lau, Dds, Pllc | Dentist | 119 Mayo St, Suite 110, Hillsborough, NC 27278 | 2020-06-26 |
| 1073080149 | Loy Anne Campbell | Occupational Therapist | 115 Oakdale Drive, Suite 8, Hillsborough, NC 27278 | 2018-10-26 |
| 1144726894 | Johanna Janssen | Physical Therapist | 1101 Bartlett Circle, Hillsborough, NC 27278 | 2018-04-02 |
| 1609305309 | Caroline Latta | Dentist | 614 Arthur Minnis Rd, Hillsborough, NC 27278 | 2017-06-06 |
| 1477089811 | Rachel Bethany Berlin | Nurse Practitioner | 276 S Churton Street, 200, Hillsborough, NC 27278 | 2017-05-04 |
| 1083155956 | Jordan Busse | Physical Therapist | 2410 Summit Dr, Hillsborough, NC 27278 | 2017-03-13 |
| 1407394174 | Dylan Thomas Twiddy | Specialist/Technologist | 3032 Prophet Dr., Hillsborough, NC 27278 | 2017-02-02 |
| 1407307572 | Nancy S Hudspeth | Counselor | 204 Saponi Drive, Hillsborough, NC 27278 | 2016-10-24 |
| 1164877536 | Andrea Marie Christian | Physical Therapist | 267 S. Churton Street, Hillsborough, NC 27278 | 2016-05-04 |
| 1578962536 | Family Advancing More Effectively, Inc. | Community/Behavioral Health | 236 Orange Grove Street, Ste. 13, Hillsborough, NC 27278 | 2014-08-15 |
| Find all providers in zip 27278 | ||||
| Taxonomy Code | 242T00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Perfusionist |
| A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient’s circulatory or respiratory function. The perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and is responsible, in consultation with the physician, for selecting the appropriate equipment and techniques to be used. |
| Notes: Source: Health Professions Career and Education Directory, American Medical Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114462280 | Adam Merritt Clark | Perfusionist | 5009 Boulder Creek Ln, Raleigh, NC 27613-6075 | 2016-12-28 |
| 1073153706 | David N Chowns Jr. | Perfusionist | 2000 Neuse Blvd, New Bern, NC 28560-3449 | 2020-01-10 |
| 1083177448 | Kyle Boatwright | Perfusionist | 257 Mcdowell St Ste 300, Asheville, NC 28803-2606 | 2019-04-11 |
| 1639632003 | Margaret A Relle | Perfusionist | 257 Mcdowell St Ste 300, Asheville, NC 28803-2606 | 2019-04-11 |
| 1780147157 | Jamison Goldstein | Perfusionist | 257 Mcdowell St, Asheville, NC 28803-2606 | 2019-04-11 |
| 1851854210 | Sebastian Gilmore | Perfusionist | 257 Mcdowell St Ste 300, Asheville, NC 28803-2606 | 2019-04-11 |
| 1578026936 | Luke Boganny | Perfusionist | 257 Mcdowell St Ste 300, Asheville, NC 28803-2606 | 2019-04-11 |
| 1326558719 | Susan Kelly Schneider | Perfusionist | 1100 Tunnel Rd, Asheville, NC 28805-2576 | 2017-10-11 |
| 1699112771 | Cassandra Marie Garland | Perfusionist | 115 Heart Dr, East Carolina Heart Institute At Ecu, Greenville, NC 27834-8944 | 2013-05-29 |
| 1013354356 | Sally Kirsten Stoner | Perfusionist | 115 Heart Dr, East Carolina Heart Institute At Ecu, Greenville, NC 27834-8944 | 2013-05-28 |
| Find all providers with the same taxonomy | ||||
| City | HILLSBOROUGH |
| Zip Code | 27278 |
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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.