MR. GEORGE WESLEY CLARK (NPI# 1750927075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750927075 |
Entity Type | Individual |
Full Name | MR. GEORGE WESLEY CLARK |
Credential | CRM |
Practice Address |
3647 Highway 39 Klamath Falls OR 97603-2612 |
Practice Telephone | 5418845244 |
Mailing Telephone | 5418845244 |
Enumeration Date | 2019-11-21 |
Last Update Date | 2020-10-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers | ||
N | 374700000X | Technician | OR | Nursing Service Related Providers | |
N | 175T00000X | Peer Specialist | Other Service Providers | ||
Y | 175T00000X | Peer Specialist | OR | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083099279 | George Clark | Assisted Living Facility | P13 Avon Dr, East Windsor Nj, NJ 08520 | 2015-07-29 |
1285900746 | George Wesley Clark | Surgery | 2049 Snapdragon Ln, Alpine, CA 91901-1304 | 2012-03-29 |
1699007807 | George James Clark | Pharmacist | 9338 215th Pl, Queens Village, NY 11428-1712 | 2010-02-12 |
1851542534 | George Warren Clark | Social Worker | 6750 Lombardy Dr, Chelsea, MI 48118-9586 | 2008-10-01 |
1043320773 | George R Clark | Dentist | 610 Old Campbell Rd, Suite 116, Richardson, TX 75080 | 2006-08-30 |
1700890415 | George B Clark | Dentist | 430 Kenhorst Blvd, Reading, PA 19611-1830 | 2006-07-28 |
1780619403 | George Barnes Clark II | Registered Nurse | 4301 West 7th St, Code 112lr, Little Rock, AR 72205-0000 | 2006-07-11 |
1013914126 | George L Clark | Family Medicine | 8740 Rivers Ave, North Charleston, SC 29406-9211 | 2005-07-05 |
1801452040 | George Clark | Social Worker | 105 Merrick St, Worcester, MA 01609-1937 | 2019-05-14 |
1780968776 | George Clark | Pharmacist | 21828 23 Mile Rd, Macomb, MI 48042-4422 | 2011-10-07 |
Street Address |
3647 HIGHWAY 39 |
City | KLAMATH FALLS |
State | OR |
Zip Code | 97603-2612 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982901120 | Sonja Ann Wilder | Counselor | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2011-02-24 |
1043828619 | Bobby Lee Black | Technician, Other | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2020-07-20 |
1831707397 | Sarah Georgia Covert | Technician, Other | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2020-07-20 |
1972129419 | Hailey Kendall Babcock | Counselor | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2020-06-21 |
1255950275 | Amiee Michele Grimes I | Technician/Technologist | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2020-04-09 |
1124654215 | Cheyenne Renee Massey | Technician/Technologist | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2020-03-20 |
1992330393 | Dean Foster Jones | Peer Specialist | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2020-03-05 |
1780229872 | Missy R Say | Technician/Technologist | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2019-11-12 |
1346885779 | Sabrina Flint Garcia | Technician/Technologist | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2019-11-08 |
1194379073 | Cody Flanders | Technician/Technologist | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2019-07-29 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790323699 | Mike Hampson | Counselor | 3203 Vandenberg Road, Klamath Falls, OR 97603 | 2019-12-11 |
1356858369 | Scott Richardson | Community Based Residential Treatment Facility, Mental Illness | 3934 Rio Vista Way, Klamath Falls, OR 97603 | 2017-12-29 |
1720518392 | Maile Kalus | Counselor | 3647 Or-39, Klamath Falls, OR 97603 | 2017-06-15 |
1174067201 | Amber Wu | Audiologist | 4036 S 6th St Ste 3, Klamath Falls, OR 97603 | 2016-12-08 |
1568870681 | Nathan William Bailey | Dentist | 2301 Mountain View Blvd, Suite D, Klamath Falls, OR 97603 | 2014-08-01 |
1376987784 | Janice Marie Heiney | Denturist | 2607 Crosby Ave, Klamath Falls, OR 97603 | 2013-04-29 |
1083958011 | John W Cooper | Denturist | 3949 Shasta Way, Klamath Falls, OR 97603 | 2012-11-15 |
1205137742 | Robert Knight | Community Health Worker | 3314 Vandenburg Rd., Klamath Falls, OR 97603 | 2010-11-16 |
1841526431 | Tim R Jones | Counselor | 3949 South 6th St, Klamath Falls, OR 97603 | 2009-11-02 |
1316135833 | Ernest Thompson O'neal | Emergency Medicine | 211 Arnold Ave. Ste 15, Klamath Falls, OR 97603 | 2007-10-10 |
Find all providers in zip 97603 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013514827 | Kassie Anderson | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-10-05 |
1821604828 | Ryan Matthew Conrady | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-16 |
1710595160 | Katrina V Hopf | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-07-21 |
1609402015 | Jason William Lee | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-03-17 |
1992330393 | Dean Foster Jones | Peer Specialist | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2020-03-05 |
1720639669 | Erin Reeves | Peer Specialist | 2230 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2019-09-23 |
1437704111 | David Anthony Gress | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2019-08-08 |
1235784133 | Dara Lee Heath | Peer Specialist | 2545 N Eldorado Ave, Klamath Falls, OR 97601-6423 | 2019-08-07 |
1225520877 | Spokes Unlimited | Peer Specialist | 1006 Main St, Klamath Falls, OR 97601-5813 | 2018-05-30 |
1720584386 | Donovan Jones | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2018-04-03 |
Find all providers in KLAMATH FALLS |
City | KLAMATH FALLS |
Zip Code | 97603 |
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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.