CLARK FAMILY MEDICINE, LLC (NPI# 1841435138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841435138 |
| Entity Type | Organization |
| Organization Name | CLARK FAMILY MEDICINE, LLC |
| Practice Address |
1200 E Woodhurst Dr Suite Q-200 Springfield MO 65804-4261 |
| Practice Telephone | 4178815639 |
| Practice Fax Number | 4178815664 |
| Mailing Telephone | 4178815639 |
| Mailing Fax Number | 4178815664 |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2008-12-16 |
| Authorized Official Name | DR. JONATHAN LEE CLARK (PHYSICIAN) |
| Authorized Official Telephone | 4178815639 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
1200 E WOODHURST DR SUITE Q-200 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-4261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366444663 | Thomas Joseph Meyer | Dentist | 1200 E Woodhurst Dr, Ste H200, Springfield, MO 65804-3776 | 2005-06-01 |
| 1770031759 | Patricia Wagner | Nurse Practitioner | 1200 E Woodhurst Dr, Q200, Springfield, MO 65804-4261 | 2016-09-19 |
| 1356700181 | Glen H Petteway, D.d.s., P.C. | Dentist | 1200 E Woodhurst Dr, Bld T, Suite 300, Springfield, MO 65804-4261 | 2016-02-22 |
| 1043691462 | Ascend Dental Design, LLC | Clinic/Center | 1200 E Woodhurst Dr, Building U, Springfield, MO 65804-4240 | 2015-06-11 |
| 1699170159 | Geosling Chiropractic Clinic, Inc | Clinic/Center | 1200 E Woodhurst Dr, Suite L200, Springfield, MO 65804-4261 | 2014-10-27 |
| 1336560010 | Thomas F, Hoff, Dds, LLC | Dentist | 1200 E Woodhurst Dr, Building F Suite 100, Springfield, MO 65807-4261 | 2013-12-23 |
| 1801234828 | Derek J Magers | Dentist | 1200 E Woodhurst Dr, Building U, Springfield, MO 65804-4261 | 2013-06-12 |
| 1073805776 | Wellness Concepts Clinic | Chiropractor | 1200 E Woodhurst Dr, Suite R300, Springfield, MO 65804-4261 | 2011-05-12 |
| 1124310107 | Candace Wawra | Hearing Instrument Specialist | 1200 E Woodhurst Dr, Suite Q Building 100, Springfield, MO 65804-4261 | 2011-05-09 |
| 1437450970 | Springfield Hearing Center | Hearing Instrument Specialist | 1200 E Woodhurst Dr, Suite Q-100, Springfield, MO 65804-4261 | 2010-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1730790874 | Janice G. Sadaya-conda M.d., Pllc | Clinic/Center | 6128 Brandon Ave Ste 225, Springfield, VA 22150-2640 | 2020-08-12 |
| 1639612880 | Icco LLC | Clinic/Center | 5781 Main Street, Springfield, OR 97478 | 2016-11-21 |
| 1164841912 | Yellow Springs Primary Care, Inc | Clinic/Center | 2608 E High St, Springfield, OH 45505-1454 | 2014-04-09 |
| 1891125480 | Western Massachusetts Primary Care PC | Clinic/Center | 405 Armory St, Springfield, MA 01104-2305 | 2013-11-18 |
| 1629364351 | Spring Valley Family Care | Clinic/Center | 27 Springfield Pike, Springfield, WV 26763 | 2011-06-21 |
| 1881193670 | 417 Health & Wellness | Clinic/Center | 1850 S Stewart Ave, Springfield, MO 65804-2519 | 2018-02-07 |
| 1588057533 | Quest Primary Care LLC | Clinic/Center | 1176 E Home Rd, Springfield, OH 45503-2726 | 2015-03-16 |
| 1851718712 | Community Health Clinic Pllc | Clinic/Center | 80 Congress St, Springfield, MA 01104-3564 | 2014-03-27 |
| 1518309426 | Burton Hills Primary Care, LLC | Clinic/Center | 2662 Memorial Blvd, Springfield, TN 37172 | 2013-07-19 |
| 1922350099 | Board of Trustees of Southern Illinois University | Clinic/Center | 5220 S 6th Street Rd, Suite 1200, Springfield, IL 62703-5735 | 2012-10-12 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
Please comment or provide details below to improve the information on CLARK FAMILY MEDICINE, LLC.
| 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.