MRS. STEPHANIE DIANE CLARK (NPI# 1760816326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760816326 |
| Entity Type | Individual |
| Full Name | MRS. STEPHANIE DIANE CLARK |
| Practice Address |
4613 Se 41st St Del City OK 73115-3703 |
| Practice Telephone | 4056357856 |
| Practice Fax Number | 4056020802 |
| Mailing Telephone | 4056357856 |
| Mailing Fax Number | 4056020802 |
| Enumeration Date | 2013-08-30 |
| Last Update Date | 2013-08-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922612605 | Stephanie Clark | Massage Therapist | 15227 Spring Cor, San Antonio, TX 78247-1693 | 2020-09-01 |
| 1811516156 | Stephanie Clark | Social Worker | 10185 Isle St, Parker, CO 80134-5788 | 2020-04-15 |
| 1306486444 | Stephanie Clark | Licensed Practical Nurse | 636 Clay Ave Uppr, Rochester, NY 14613-1030 | 2020-01-07 |
| 1841681046 | Stephanie Clark | Technician, Other | 2917 S Ash Ct, Broken Arrow, OK 74012-7804 | 2015-02-09 |
| 1538447560 | Stephanie Renae Clark | Physical Therapist | 927 Battlefield Blvd N, Suite 200, Chesapeake, VA 23320-4853 | 2011-07-25 |
| 1932330545 | Stephanie D Clark | Social Worker | 16581 Us Highway 17 N Ste 600, Hampstead, NC 28443-7451 | 2009-07-30 |
| 1487719787 | Stephanie Clark | Licensed Practical Nurse | 55 Ramble Hill Lane, Millbrook, NY 12545 | 2006-12-27 |
| 1811057425 | Stephanie Clark | Dentist | 7601 A Germantown Ave, Philadelphia, PA 19119 | 2006-12-12 |
| 1700864733 | Stephanie Elaine Clark | Audiologist | 13934 N 59th Ave, Ste 120, Glendale, AZ 85306-4167 | 2006-01-09 |
| 1851395453 | Stephanie Clark | Chiropractor | 3 Elmwood Rd, Hancock, NH 03449-5629 | 2005-06-10 |
| Street Address |
4613 SE 41ST ST |
| City | DEL CITY |
| State | OK |
| Zip Code | 73115-3703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639776222 | Physicians Choice Dialysis of Midwest City LLC | Technician, Other | 3200 Se 29th Street, Del City, OK 73115 | 2020-10-06 |
| 1942784715 | Iacc/ehi Nw, LLC | General Acute Care Hospital | 4801 S.e. 15th Street, Del City, OK 73115 | 2018-09-18 |
| 1285164392 | Jerry Medlock | Peer Specialist | 4312 Vfw Dr. Apt # 7, 4312 Vfw Dr. Apt # 7, Del City, OK 73115 | 2017-06-13 |
| 1326425588 | Peace of Mind Pediatrics Pllc | Clinic/Center | 5476 Main Street, 104, Del City, OK 73115 | 2015-04-27 |
| 1588077044 | Latasha Aujena Walker | Case Management | 4337 Se15th, Del City, OK 73115 | 2014-06-03 |
| 1164834701 | Affordable Dentures-midwest City, P.C. | Dentist | 5301 Main Street, Suite 111, Del City, OK 73115 | 2014-06-02 |
| 1629488028 | Nikke Sogunro | Counselor | 3517 Ridglea Ct., Del City, OK 73115 | 2014-05-07 |
| 1033539358 | Shelli Holtsman | Counselor | 4329 Se 40th Street, Del City, OK 73115 | 2014-04-25 |
| 1215238514 | Tonya Dailwayne Wilson | Counselor | 4016 S.e. 24th Street, Del City, OK 73115 | 2010-11-03 |
| 1851611099 | Kelly Camille Kingsley | Behavioral Analyst | 4018 Se 11th Street, Del City, OK 73115 | 2010-06-10 |
| Find all providers in zip 73115 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811503329 | Shasta Davis | Case Manager/Care Coordinator | 4753 Del Aire Dr, Del City, OK 73115-4350 | 2020-09-20 |
| 1063035178 | Shallette R. Starnes | Case Manager/Care Coordinator | 3120 Beechwood Dr, Del City, OK 73115-1316 | 2020-05-22 |
| 1417596404 | Sara Nicole George | Case Manager/Care Coordinator | 5113 Se 15th St Ste A, Del City, OK 73115-3952 | 2019-12-23 |
| 1639722564 | Blair Johnson | Case Manager/Care Coordinator | 4762 Woodview Dr, Del City, OK 73115-4224 | 2019-07-19 |
| 1649834714 | Uceta Denise White | Case Manager/Care Coordinator | 4632 Se 24th St, Del City, OK 73115-4110 | 2019-04-24 |
| 1649736554 | Mellisia Jones | Case Manager/Care Coordinator | 4725 S Bryant Ave, Del City, OK 73135-1011 | 2019-02-15 |
| 1346756244 | Dustin W Mccaslin | Case Manager/Care Coordinator | 3505 Se 22nd St, Del City, OK 73115-1543 | 2017-12-14 |
| 1952833972 | Janna Nichole Sharp | Case Manager/Care Coordinator | 3929 Se 27th St, Del City, OK 73115-2619 | 2017-03-29 |
| 1447623418 | Kayla Barczak | Case Manager/Care Coordinator | 3945 Se 15th St Ste 107, Del City, OK 73115-2247 | 2015-11-12 |
| 1790156305 | Troy Lee Anderson | Case Manager/Care Coordinator | 4313 Se 13th St, Del City, OK 73115-3021 | 2015-10-08 |
| Find all providers in DEL 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.