NICHOLAS CLARK (NPI# 1740816842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740816842 |
| Entity Type | Individual |
| Full Name | NICHOLAS CLARK |
| Practice Address |
3551 Roger Brooke Dr Jbsa Ft Sam Houston TX 78234-4504 |
| Practice Telephone | 2102207638 |
| Mailing Telephone | 2102207638 |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| 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 |
|---|---|---|---|---|
| 1760710958 | Nicholas L Clark | Optometrist | 2185 Nw 2nd St, Mcminnville, OR 97128-9108 | 2009-11-25 |
| 1306172721 | Nicholas Eugene Clark | Specialist/Technologist | 8401 Valley Ranch Pkwy E, Irving, TX 75063-5405 | 2009-10-20 |
| 1043841430 | Nicholas Clark | Behavior Technician | 2925 Dean Pkwy Ste 300, Minneapolis, MN 55416-7700 | 2020-02-04 |
| 1386106201 | Nicholas William Clark | Student in an Organized Health Care Education/Training Program | 2301 Erwin Rd, Durham, NC 27705-4699 | 2019-04-01 |
| 1316430564 | Nicholas E. Clark | Nurse Anesthetist, Certified Registered | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 | 2018-06-12 |
| 1538657465 | Nicholas Clark | Licensed Practical Nurse | 350 City View Dr Ste 206, Evanston, WY 82930 | 2018-04-26 |
| 1407235724 | Nicholas Clark | Orthopaedic Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2015-05-19 |
| 1326457375 | Nicholas Clark | Social Worker | 690 Edison Way, Reno, NV 89502-4100 | 2014-08-04 |
| 1356760508 | Nicholas Samuel Clark | Anesthesiology | 2331 Franklin Rd Sw, Roanoke, VA 24014-1111 | 2014-04-15 |
| 1942596283 | Nicholas Clark | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2011-06-24 |
| Street Address |
3551 ROGER BROOKE DR |
| City | JBSA FT SAM HOUSTON |
| State | TX |
| Zip Code | 78234-4504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616398 | Emily M Covais | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-10-09 |
| 1730793191 | George Brett Pulvermacher | Physical Therapist | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-09-03 |
| 1053922559 | Aline Noelle Ulloa | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-08-10 |
| 1538778931 | Caroline Elizabeth Conner | Pharmacist | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-07-31 |
| 1487263406 | Mary Michelle Ayres | Nurse Practitioner | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-07-27 |
| 1265040612 | Suzanne Elise Laux | Nurse Practitioner | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-07-21 |
| 1801414677 | James Martin Maloney | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-07-08 |
| 1861019473 | Jonathan Lee Custer | Nurse Anesthetist, Certified Registered | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-06-30 |
| 1528685336 | Erin Wheeler | Physical Therapist | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-06-26 |
| 1821614322 | Ryan Hyatt | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942884 | Thomas Ballas | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa-fort Sam Houston, Department of Behavioral Medicine-mche-dbm, San Antonio, TX 78234 | 2020-08-17 |
| 1124657366 | Wendy Harris | Pharmacist | 3041 Garden Ave, Fort Sam Houston, TX 78234 | 2020-04-08 |
| 1215564729 | Travis Frantz | Student in an Organized Health Care Education/Training Program | 3551 Rodger Brooke Drive, Jbsa Fort Sam Houston, TX 78234 | 2020-03-25 |
| 1508492695 | Matthew Grossmann | Student in an Organized Health Care Education/Training Program | San Antonio Military Medical Center, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234 | 2020-03-20 |
| 1235793407 | Jessica Maria May Franklin | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa Fort Sam Houston, San Antonio, TX 78234 | 2019-04-23 |
| 1730663477 | Glen Snyder | Military Health Care Provider | 3488 Garden Ave Anderson Hall, Fort Sam Houston, San Antonio, TX 78234 | 2018-09-19 |
| 1265919336 | Ashley Elizabeth Malawey | Military Health Care Provider | 3222 Cpl Johnson Road, San Antonio, TX 78234 | 2018-07-23 |
| 1053805515 | Rene Espinosa | Social Worker | San Antonio Medical Center, 3551 Roger Brooke Dr, Jbsa, TX 78234 | 2018-06-19 |
| 1235622333 | Melanie Edith Rivera | Military Health Care Provider | 3600 Roger Brooke Drive, San Antonio, TX 78234 | 2018-06-13 |
| 1063909158 | Benjamin Walker Appelo | General Practice | San Antonio Mil Med Center 3551 Roger Brooke Dr, Mche-zdm-m, San Antonio, TX 78234 | 2018-04-16 |
| Find all providers in zip 78234 | ||||
| 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 |
|---|---|---|---|---|
| 1023616398 | Emily M Covais | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-10-09 |
| 1053922559 | Aline Noelle Ulloa | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-08-10 |
| 1801414677 | James Martin Maloney | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-07-08 |
| 1821614322 | Ryan Hyatt | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-06-19 |
| 1629692991 | Martin Joseph De Vita | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-06-02 |
| 1598388852 | Justin Morris | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-05-21 |
| 1407478951 | Steven Francis Capen | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-05-07 |
| 1669093191 | Jesse Lee Fitzgerald | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-05-06 |
| 1174144760 | Gabriel Mason | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-05-05 |
| 1497375570 | John Michael Black | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-04-20 |
| Find all providers in JBSA FT SAM HOUSTON | ||||
| City | JBSA FT SAM HOUSTON |
| Zip Code | 78234 |
Please comment or provide details below to improve the information on NICHOLAS 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.