DR. DEBRA CLARK (NPI# 1962473397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962473397 |
| Entity Type | Individual |
| Full Name | DR. DEBRA CLARK |
| Credential | M.D. |
| Practice Address |
1409 Rt 9 Keeseville NY 12944-2845 |
| Practice Telephone | 5188347271 |
| Practice Fax Number | 5188347086 |
| Mailing Telephone | 5188347271 |
| Mailing Fax Number | 5188347086 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2012-03-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 1750471 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01604324 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336525625 | Debra Clark | Nurse Practitioner | 1040 Vinehaven Dr Ne, Concord, NC 28025-2438 | 2015-08-10 |
| 1255683330 | Debra Ashley Clark | Audiologist | 1720 Peachtree St Nw Ste 200, Atlanta, GA 30309-2440 | 2012-10-12 |
| 1871816041 | Debra Striler Clark | Psychologist | 71 Walnut, Suite 109, Rochester, MI 48307-2073 | 2010-03-02 |
| 1952539785 | Debra Diane Clark | Reflexologist | 104 53rd Ave E, Bradenton, FL 34203-4702 | 2009-07-01 |
| 1720178650 | Debra Sue Clark | Physical Therapist | 3500 S Boulevard, Suite A, Edmond, OK 73013-5490 | 2006-10-13 |
| 1609896943 | Debra Jean Clark | Counselor | 10 Market St, Suite 5, Oneonta, NY 13820-2655 | 2006-07-20 |
| 1154665669 | Debra Mae Clark | Physical Therapy Assistant | 1502 E Centennial Dr, Pittsburg, KS 66762-6718 | 2012-11-21 |
| 1407144215 | Debra Lou Clark | Counselor | 3 Bridge St, Carthage, NY 13619-1353 | 2011-07-13 |
| 1790003218 | Debra Lynn Ann Clark | Licensed Practical Nurse | 116 Second St, Greenland, MI 49929 | 2010-05-07 |
| 1437477080 | Debra E Clark | Psychologist | 110 N Cayuga St, Ithaca, NY 14850-4326 | 2010-05-06 |
| Street Address |
1409 RT 9 |
| City | KEESEVILLE |
| State | NY |
| Zip Code | 12944-2845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952841702 | Ellen Supinski | Specialist | 1701 Front Street, Keeseville, NY 12944 | 2017-02-27 |
| 1326385857 | Jessica Drinkwine | Specialist | 1850 Route 22, Keeseville, NY 12944 | 2013-01-03 |
| 1891160388 | Melody Hyatt | Early Intervention Provider Agency | 1717 Front Street, Keesville, NY 12944-0000 | 2015-12-09 |
| 1639605397 | Nancy Simington | Occupational Therapy Assistant | 46 School St Apt 1, Keeseville, NY 12944-1014 | 2017-05-02 |
| 1831423367 | Heidemarie Macdougal | Licensed Practical Nurse | 40 Cedar Ct, Keeseville, NY 12944-1100 | 2009-10-01 |
| 1891251641 | Paul Schmid | Taxi | 55 Cedar Ct, Keeseville, NY 12944-1134 | 2019-02-18 |
| 1366745556 | Maria Rheaume | Psychologist | 1 Mill St, Keeseville, NY 12944-1215 | 2010-12-10 |
| 1205230851 | Tara Parton | Licensed Practical Nurse | 85 Chesterfield St, Keeseville, NY 12944-1229 | 2014-10-10 |
| 1104139245 | Marshia Ellen Desorcie | Social Worker | 92 Clinton St, Keeseville, NY 12944-1261 | 2010-07-19 |
| 1770799298 | Judith Renee Feigenbaum | Genetic Counselor, MS | 61 River St, Keeseville, NY 12944-1276 | 2007-05-14 |
| Find all providers in zip 12944 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1336749571 | Chowdhury Medical PC | Family Medicine | 155 Alkier St, Brentwood, NY 11717-5129 | 2020-10-27 |
| 1356940084 | Rebecca Jean Smouse | Family Medicine | 1107 Prendergast Ave, Jamestown, NY 14701-3315 | 2020-10-23 |
| 1336748136 | Rapha House Calls | Family Medicine | 2 Fernglade Ct, Chester, NY 10918-2637 | 2020-10-22 |
| 1174122980 | Richmond Health Partners Ipa LLC | Family Medicine | 1161 Victory Blvd, Staten Island, NY 10301-3621 | 2020-10-22 |
| 1730787128 | Michael C Secallus | Family Medicine | 66 Kirkwood Gdns, Kirkwood, NY 13795-1623 | 2020-10-16 |
| 1861099053 | Julia Gross Family Health Nurse Practitioner, Pllc | Family Medicine | 950 Route 146 Ste 100, Clifton Park, NY 12065-3667 | 2020-10-01 |
| 1013523190 | Steinway Hope Medical LLC | Family Medicine | 8829 54th Ave Fl 2, Elmhurst, NY 11373-4543 | 2020-09-23 |
| 1538774500 | Jenny Brandt | Family Medicine | 3048 Sunset Ln # 2, Schenectady, NY 12303-5528 | 2020-09-15 |
| 1992319016 | Sarah Glaser | Family Medicine | 30 W 24th St, New York, NY 10010-3207 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | KEESEVILLE |
| Zip Code | 12944 |
Please comment or provide details below to improve the information on DR. DEBRA CLARK.
| 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.