JOHANNA THERESA CLARK (NPI# 1750942892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750942892 |
| Entity Type | Individual |
| Full Name | JOHANNA THERESA CLARK |
| Other Name | JOHANNA THERESA COLLINS |
| Credential | ARNP |
| Practice Address |
3640 Middlebury Rd Iowa City IA 52245-2712 |
| Mailing Address |
200 Hawkins Dr Iowa City IA 52242-1009 |
| Practice Telephone | 3194676789 |
| Practice Fax Number | 3194677400 |
| Mailing Telephone | 3193561616 |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2019-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | A154199 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A154199 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1632 Sycamore St, Iowa City, IA 522406044 | 3193848822 | |
| 200 Hawkins Dr, Iowa City, IA 522421009 | 5633704582 | |
| 201 S Clinton St Ste 168, Iowa City, IA 522404034 | 3193848877 | |
| 2510 Corridor Way Ste 6a, Coralville, IA 522417604 | 3193848500 | |
| 720 Pacha Pkwy Ste 1, North Liberty, IA 523174797 | 3193848801 | |
| 767 Mormon Trek Blvd, Iowa City, IA 522461812 | 3193848333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508962408 | Johanna Daniela Clark | Social Worker | 19 Campus Blvd Ste 102, Delaware County Professional Services, Newtown Square, PA 19073 | 2006-09-16 |
| 1487854162 | Johanna J Clark | Specialist/Technologist, Other | 8409 Dunwoody Pl, Atlanta, GA 30350-3367 | 2007-07-20 |
| Street Address |
3640 MIDDLEBURY RD |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52245-2712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437148285 | Matthew L Lanternier | Family Medicine | 3640 Middlebury Rd, Iowa City, IA 52245-2712 | 2005-10-14 |
| 1689204141 | April Elizabeth Allen | Physician Assistant | 3640 Middlebury Rd, Iowa City, IA 52245-2712 | 2020-01-23 |
| 1669959573 | State University of Iowa | Clinic/Center | 3640 Middlebury Rd, Iowa City, IA 52245-2712 | 2018-07-24 |
| 1598292534 | Minh-anh Pham | Nurse Practitioner | 3640 Middlebury Rd, Iowa City, IA 52245-2712 | 2017-05-22 |
| 1790226629 | Tinu Bastian | Nurse Practitioner | 3640 Middlebury Rd, Iowa City, IA 52245-2712 | 2017-03-11 |
| 1093251381 | Tiffany Sorensen | Physician Assistant | 3640 Middlebury Rd, Iowa City, IA 52245-2712 | 2017-01-11 |
| 1922458405 | Jessica Lynn Alston | Family Medicine | 3640 Middlebury Rd, Iowa City, IA 52245-2712 | 2016-06-15 |
| 1083089189 | Elizabeth Mary Highland-fonder | Nurse Practitioner | 3640 Middlebury Rd, Iowa City, IA 52245 | 2015-12-01 |
| 1285027847 | Corey Lynne Andrade | Physician Assistant | 3640 Middlebury Rd, Iowa City, IA 52245 | 2015-03-06 |
| 1548692585 | Anne M Daggett | Registered Nurse | 3640 Middlebury Rd, Iowa City, IA 52245-2712 | 2013-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730699356 | Mary Beth Shapcott | Registered Nurse | 500 East Market St., Mercy Hospital Diabetes Education, Iowa City, IA 52245 | 2017-10-10 |
| 1366703167 | Elizabeth Bright | Occupational Therapist | 540 E. Jefferson Street., Ste.302, Iowa City, IA 52245 | 2012-06-07 |
| 1043518368 | Robert Brian Goffstein | Ophthalmology | 403 North 7th Ave, Iowa City, IA 52245 | 2011-03-10 |
| 1750682936 | Robert Alvin Blair | Dentist | 134 Broadmoor Lane, Iowa City, IA 52245 | 2010-11-04 |
| 1215167457 | Laura J Ericson | Occupational Therapist | 540 E Jefferson Street, Ste. 302, Iowa City, IA 52245 | 2009-07-22 |
| 1780818294 | Kathryn Leigh Bossen | Physical Therapist | 540 E. Jefferson Street, Ste. 302, Iowa City, IA 52245 | 2009-05-12 |
| 1073751095 | Jessica L Keeran | Physical Therapist | 2751 Northgate Dr. Ne, Iowa City, IA 52245 | 2009-01-29 |
| 1437330370 | Francine Mardarello Hunnicutt | Marriage & Family Therapist | 1610 East College St, Iowa City, IA 52245 | 2007-11-20 |
| 1659574853 | Joan Victoria Rinner | Marriage & Family Therapist | 121 University Services Building, University of Iowa, Iowa City, IA 52245 | 2007-06-06 |
| 1053529966 | Steve Bernt Hammerstrom | Chiropractor | 373 B Scott Court, Iowa City, IA 52245 | 2007-05-21 |
| Find all providers in zip 52245 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942795950 | Amber Nicole Orr | Nurse Practitioner | 540 E Jefferson St Ste 201, Iowa City, IA 52245-2460 | 2018-06-22 |
| 1689933731 | Eilene M Swartz | Nurse Practitioner | 201 S Clinton St Ste 168, Iowa City, IA 52240-4034 | 2012-05-10 |
| 1104182807 | Elizabeth L Berning | Nurse Practitioner | Veteran Affiars Medical Center, 601 Hwy 6 West, Iowa City, IA 52246 | 2012-04-06 |
| 1952566390 | Emily Jane Griffin | Nurse Practitioner | 4118 Westlawn S, Iowa City, IA 52242-1100 | 2008-07-24 |
| 1013049691 | Susan Renee Scott | Nurse Practitioner | 2941 Sierra Ct Sw, Iowa City, IA 52240-8503 | 2007-03-10 |
| 1972101533 | Lindy Pelzer | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-15 |
| 1982212973 | Karen Ann Davison | Nurse Practitioner | 601 Highway 6 W, Iowa City, IA 52246-2209 | 2020-07-16 |
| 1528683638 | Maria Tessa Witt | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-06-15 |
| 1073136974 | Frankie L Dunbar | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-05-26 |
| 1447800685 | Alysha Reese | Nurse Practitioner | 850 Orchard St, Iowa City, IA 52246-5412 | 2019-09-19 |
| Find all providers in IOWA CITY | ||||
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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.