DR. KIM P LARK (NPI# 1023009016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023009016 |
| Entity Type | Individual |
| Full Name | DR. KIM P LARK |
| Credential | D.O. |
| Practice Address |
2402 W Pierce St Suite 4-a Carlsbad NM 88220-3537 |
| Practice Telephone | 5752349964 |
| Practice Fax Number | 5752349962 |
| Mailing Telephone | 5752349964 |
| Mailing Fax Number | 5752349962 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2014-01-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A110698 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | T9592 | 05 |
| Street Address |
2402 W PIERCE ST SUITE 4-A |
| City | CARLSBAD |
| State | NM |
| Zip Code | 88220-3537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639178338 | Joseph Daniel Cross | Pharmacist | 2402 W Pierce St, Suite 1a, Carlsbad, NM 88220-3537 | 2005-07-15 |
| 1306392097 | Madeleine Drummond | Nurse Practitioner | 2402 W Pierce St, Suite 2a, Carlsbad, NM 88220-3537 | 2016-08-31 |
| 1073983011 | Crystal Mullins | Nurse Practitioner | 2402 W Pierce St, Suite 6a, Carlsbad, NM 88220-3537 | 2015-10-02 |
| 1265835284 | Apoorva Reddy Tiparti | Pharmacist | 2402 W Pierce St, Suite 1a, Carlsbad, NM 88220-3537 | 2014-10-05 |
| 1104167477 | Jill Fierro | Nurse Practitioner | 2402 W Pierce St, Ste 4a, Carlsbad, NM 88220-3537 | 2013-03-11 |
| 1942554480 | Sandya Surgical Associates | Surgery | 2402 W Pierce St, Suite 5c, Carlsbad, NM 88220-3537 | 2012-11-06 |
| 1245519115 | Raney Pediatrics | Pediatrics | 2402 W Pierce St, Suite 3 C, Carlsbad, NM 88220-3537 | 2011-08-10 |
| 1982905683 | Ida Lee Fraser | Nurse Practitioner | 2402 W Pierce St, Suite 4a, Carlsbad, NM 88220-3537 | 2010-11-11 |
| 1912216755 | Sophia Ann Villalobos | Nurse Practitioner | 2402 W Pierce St, Suite 6f, Carlsbad, NM 88220-3537 | 2010-09-28 |
| 1699918672 | Pecos Valley of New Mexico LLC | Durable Medical Equipment & Medical Supplies | 2402 W Pierce St, Suite 6e, Carlsbad, NM 88220-3537 | 2009-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083248991 | Diana P Levy | Nurse Anesthetist, Certified Registered | Carlsbad Medical Center, 2430 W Pierce St., Carlsbad, NM 88220 | 2020-02-29 |
| 1790333680 | Angela Houston | Nurse Practitioner | 202 W. Church Street, Carlsbad, NM 88220 | 2019-09-03 |
| 1265958722 | Amanda Henry | Social Worker | 3000, West Church Street, Carlsbad, NM 88220 | 2017-08-16 |
| 1952827610 | Audriana B Martinez | Physical Therapy Assistant | 1038 Pinon Ln, Carlsbad, NM 88220 | 2017-08-15 |
| 1730538265 | Amber Bojorquez | Registered Nurse | 406 N. Alameda St., Carlsbad, NM 88220 | 2016-06-06 |
| 1164887584 | Kassandra Prutsman | Specialist | 126 S. Canyon, Carlsbad, NM 88220 | 2015-12-30 |
| 1306220314 | Rocky Mountain Holdings, LLC | Ambulance | 1505 Terminal Dr, Carlsbad, NM 88220 | 2015-07-20 |
| 1578986402 | Sheryl L Dugger | Registered Nurse | 406 N. Alameda, Carlsbad, NM 88220 | 2014-01-29 |
| 1194153106 | Wellcare, Inc. | Hospice Care, Community Based | 220 S Canal St Ste B, Carlsbad, NM 88220 | 2013-10-30 |
| 1932537420 | Wellcare, Inc | Home Health | 220 S Canal St Ste A, Carlsbad, NM 88220 | 2013-10-22 |
| Find all providers in zip 88220 | ||||
| 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 |
|---|---|---|---|---|
| 1578917720 | Elinora S Madrid-carranza | Family Medicine | 6010 Hidden Valley Rd Ste 150, Carlsbad, CA 92011-4217 | 2016-04-13 |
| 1366874745 | Peggy E Denton | Family Medicine | 3823 National Parks Highway, Carlsbad, NM 88220-8822 | 2013-08-07 |
| 1265727127 | Marie Hong Shieh | Family Medicine | 2501 Navarra Dr, Unit 124, Carlsbad, CA 92009-7002 | 2011-06-17 |
| 1538464029 | Carolyn Aludino Candido | Family Medicine | 5814 Van Allen Way Ste 215, Ste. 215, Carlsbad, CA 92008-7360 | 2011-01-14 |
| 1285964916 | Jerry Dee Colling | Family Medicine | 3171 Falcon Drive, Carlsbad, CA 92008 | 2009-12-31 |
| 1831343946 | Stephen Houngzin Peck | Family Medicine | 10950 N U.S. Hwy 87, Carlsbad, TX 76934-0038 | 2008-11-17 |
| 1154539864 | Philip Richard Goodman | Family Medicine | 7535 Cadencia St, Carlsbad, CA 92009-7534 | 2007-05-18 |
| 1508921586 | Farooq A. Kayani | Family Medicine | 2330 W Pierce St, Carlsbad, NM 88220-3514 | 2006-12-27 |
| 1063585495 | Gary P Korff | Family Medicine | 2562 State St Ste D, Carlsbad, CA 92008-1663 | 2006-11-15 |
| 1790855732 | Nii Tetteh Tsuru Addy | Family Medicine | 615 W Mermod St, Carlsbad, NM 88220-4912 | 2006-11-08 |
| Find all providers in CARLSBAD | ||||
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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.