SHELLY A CLARK (NPI# 1942818646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942818646 |
| Entity Type | Individual |
| Full Name | SHELLY A CLARK |
| Practice Address |
744 W Brandon Blvd Brandon FL 33511-4902 |
| Mailing Address |
1019 Milano Cir Apt 108 Brandon FL 33511-7177 |
| Practice Telephone | 8133904684 |
| Mailing Telephone | 8133904684 |
| Enumeration Date | 2020-07-19 |
| Last Update Date | 2020-07-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487720496 | Shelly Rene Clark | Counselor | 3940 Cornhusker Hwy, Lincoln, NE 68504-1534 | 2006-11-28 |
| 1891880076 | Shelly Kay Clark | Dentist | 211 W Belt Line Rd, North Suite, Cedar Hill, TX 75104-2066 | 2006-10-04 |
| Street Address |
744 W BRANDON BLVD |
| City | BRANDON |
| State | FL |
| Zip Code | 33511-4902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720622798 | Cesar A Brito | Specialist | 744 W Brandon Blvd, Brandon, FL 33511-4902 | 2019-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295367555 | Ability Beyond Measures LLC. | Clinic/Center | 2705 Isabella Valley Court, Brandon, FL 33511 | 2020-02-05 |
| 1831744655 | Brandon Modern Dentistry, Pa | Dentist | 971 E. Bloomingdale Avenue, Brandon, FL 33511 | 2019-08-08 |
| 1487208922 | Heart and Vascular Center of Brandon, Pllc | Internal Medicine | 511 Medical Oaks Ave., Brandon, FL 33511 | 2019-08-01 |
| 1841842895 | Rebecca Harrelson | Counselor | 915 Oakfield Drive, Suite E, Brandon, FL 33511 | 2019-07-10 |
| 1043779713 | Cheryl Diane Hart | Nurse Practitioner | 888 S Parsons Ave., Brandon, FL 33511 | 2019-03-13 |
| 1306303177 | Paula J Buchwald | Nurse Practitioner | 888 S. Parsons Ave, Brandon, FL 33511 | 2019-02-27 |
| 1063993996 | Ashlee Marie Shevchenko | Speech-Language Pathologist | 602 Vondeburg Dr, Suite 201, Brandon, FL 33511 | 2018-08-28 |
| 1275023012 | Ava Cares, LLC | Assisted Living Facility | 3005 Bell Shoals Rd., Brandon, FL 33511 | 2018-05-17 |
| 1346738705 | Tampa Psychology Group | Psychologist | 1463 Oakfield Dr Ste 109, Brandon, FL 33511 | 2018-05-01 |
| 1760982987 | Suresh Lama Tamang | Counselor | 510 Vonderburg Dr, Suite# 301, Brandon, FL 33511 | 2018-02-14 |
| Find all providers in zip 33511 | ||||
| Taxonomy Code | 1744P3200X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| Specialization | Prosthetics Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720622798 | Cesar A Brito | Specialist | 744 W Brandon Blvd, Brandon, FL 33511-4902 | 2019-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093337958 | Rasheda Juandrell Tyson | Specialist | 2702 Massachusetts Ave Apt 185, Pensacola, FL 32505-3475 | 2020-05-14 |
| 1285262352 | Narotique Beauty Bar | Specialist | 20401 Nw 2nd Ave Ste 208, Miami, FL 33169-2572 | 2020-04-01 |
| 1710526892 | Tavia Sevon Richards | Specialist | 12414 Touchton Dr Apt 95, Tampa, FL 33617-1544 | 2020-01-06 |
| 1427696905 | Vanessa Lisa Gaspard | Specialist | 355 Ne 159th St, Miami, FL 33162-5007 | 2019-12-16 |
| 1316598303 | Rashawnda Thomas | Specialist | 4110 Sw 34th St Ste 22, Gainesville, FL 32608-6529 | 2019-09-22 |
| 1891352795 | Calandra Sands | Specialist | 801 S Dixie Hwy W Ste 5, Pompano Beach, FL 33060-8263 | 2019-05-26 |
| 1265990865 | Ashley Simone Kitchens | Specialist | 1418 E Busch Blvd, Tampa, FL 33612-8656 | 2019-03-04 |
| 1457819070 | Aramis Tylise Hamilton | Specialist | 1514 S Alexander St Ste 207, Plant City, FL 33563-8418 | 2019-03-04 |
| 1356805642 | Olajide A Wilkerson | Specialist | 540 Nw 165th Street Rd Ste 109, Miami, FL 33169-6304 | 2019-01-31 |
| 1033683552 | Carlise Yvette Charlot | Specialist | 1289 Windy Willows Dr, Jacksonville, FL 32225-5957 | 2019-01-17 |
| Find all providers with the same taxonomy | ||||
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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.