JONATHAN DANIEL CLARK (NPI# 1932508165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932508165 |
| Entity Type | Individual |
| Full Name | JONATHAN DANIEL CLARK |
| Credential | MS, LAT, ATC |
| Practice Address |
11306 County Line Rd Madison AL 35756-2011 |
| Mailing Address |
925 Franklin St Se Ste A Huntsville AL 35801-4307 |
| Practice Telephone | 2562165313 |
| Mailing Telephone | 2562655000 |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2014-08-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1378 | AL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BOC CERTIFIED ATHLETIC TRAINER | 2000006545 | 01 | |
| AL | STATE OF ALABAMA BOARD OF ATHLETIC TRAINERS | 1378 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790246270 | Jonathan Andrew Clark | Nurse Practitioner | 5042 12th Ave N, St Petersburg, FL 33710-6011 | 2019-03-27 |
| 1720573447 | Jonathan Clark | Specialist/Technologist | 1214 Highland Lake Cir, Decatur, GA 30033-3460 | 2018-06-25 |
| 1376033381 | Jonathan Clark | Psychologist | 150 Payson Rd, Chestnut Hill, MA 02467-3272 | 2018-05-15 |
| 1871046748 | Jonathan Clark | Acupuncturist | 1803 N Wickham Rd, Melbourne, FL 32935-8155 | 2016-07-27 |
| 1831563105 | Jonathan Michael Clark | Counselor | 1522b Gregg St, Philadelphia, PA 19115-4283 | 2015-11-23 |
| 1841696820 | Jonathan Clark | Specialist/Technologist | 14049 Scenic Hwy, Lookout Mountain, GA 30750-4100 | 2014-11-18 |
| 1851645717 | Jonathan Clark | Student in an Organized Health Care Education/Training Program | 206 Finley Forest Dr, Chapel Hill, NC 27517-8689 | 2012-10-30 |
| 1184682866 | Jonathan Scott Clark | Family Medicine | 1103 Dewey Ave, Poteau, OK 74953-4411 | 2006-05-03 |
| 1851740724 | Jonathan J Clark Jr. | Social Worker | 5901 E 7th St, Long Beach, CA 90822-5201 | 2016-06-10 |
| 1679943328 | Jonathan Wilson Clark | Occupational Therapist | 3175 Pocahontas Rd, Baker City, OR 97814-1434 | 2015-10-06 |
| Street Address |
11306 COUNTY LINE RD |
| City | MADISON |
| State | AL |
| Zip Code | 35756-2011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386191914 | Jennifer Ryder | Nurse Practitioner | 8 Ross Street, Madison, AL 35756 | 2016-09-01 |
| 1700256252 | Community Urgent Care of Madison, Inc | Family Medicine | 30694 Highway 72, Suite E, Madison, AL 35756 | 2015-09-28 |
| 1609271220 | Corner Crossing LLC | Pharmacy | 30694 Highway 72 West, Suite A, Huntsville, AL 35756 | 2014-10-24 |
| 1881941482 | Darleen Rebecca Morris | Physical Therapist | 12110 County Line Rd Ste B, Madison, AL 35756 | 2012-08-14 |
| 1528125622 | Mary Bryant | Physical Therapist | 30630 Hwy 72 West, Madison, AL 35756 | 2007-01-02 |
| 1689730194 | Mayra H Blanche | Occupational Therapist | 30630 Hwy. 72 West, Madison, AL 35756 | 2006-12-29 |
| 1952357907 | Giles Henry Vaden | Counselor | 140 Fields Pond Drive, Madison, AL 35756 | 2006-05-25 |
| 1881816023 | Heather Grogan | Occupational Therapist | 30630 Hwy. 72 West, Madison, AL 35756 | 2007-05-03 |
| 1255498358 | Judy Hawke | Physical Therapist | 30630 Hwy. 72 West, Madison, AL 35756 | 2007-01-02 |
| 1700943800 | Bryan Brazelle | Physical Therapist | 30630 Hwy 72 West, Madison, AL 35756 | 2007-01-02 |
| Find all providers in zip 35756 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
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| 1497396428 | Austin Drake | Specialist/Technologist | 201 Planters Cv, Madison, MS 39110-7988 | 2019-10-01 |
| 1407400112 | Zafir Georges-abeyie | Specialist/Technologist | 1920 Kendall Ave Apt 2, Madison, WI 53726-4008 | 2019-07-31 |
| 1023675212 | Kennedy Wayne Germany Jr. | Specialist/Technologist | 813 Seashell Cove, Madison, TN 37115 | 2019-05-22 |
| 1457810673 | Leah Smith | Specialist/Technologist | 1436 Monroe Street, Madison, WI 53711 | 2019-03-18 |
| 1710451927 | Patrick Louis Johnson | Specialist/Technologist | 103 Lynbrook Blvd, Madison, AL 35758-8137 | 2019-01-22 |
| 1518430735 | Jennifer Cecil | Specialist/Technologist | 126 Spring Water Dr, Madison, AL 35758-1391 | 2019-01-10 |
| 1073086336 | John M Spillman | Specialist/Technologist | 1913 Neelys Bend Rd, Madison, TN 37115-5811 | 2019-01-09 |
| 1932677309 | Garrett Hansen | Specialist/Technologist | 402 Northbay Dr, Madison, MS 39110-8859 | 2018-11-05 |
| 1891284303 | Lisbeth Smith | Specialist/Technologist | 920 Spring St, Madison, WI 53715-3603 | 2018-05-09 |
| Find all providers in MADISON | ||||
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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.