CLARK VAN DEN BERGHE (NPI# 1053752675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053752675 |
| Entity Type | Individual |
| Full Name | CLARK VAN DEN BERGHE |
| Credential | MD |
| Practice Address |
269 Union St Lynn MA 01901-1314 |
| Practice Telephone | 7815962502 |
| Practice Fax Number | 7815963966 |
| Mailing Telephone | (781) 581-3900 |
| Mailing Fax Number | 7815981050 |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2017-09-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 256393 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
269 UNION ST |
| City | LYNN |
| State | MA |
| Zip Code | 01901-1314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033111711 | Melinda D Jones | Nurse Practitioner | 269 Union St, Lynn, MA 01901-1314 | 2005-08-12 |
| 1245830900 | Angel Felix Rosado Mencia | Dentist | 269 Union St, Lynn, MA 01901-1314 | 2020-10-30 |
| 1114525342 | Nerla Batraville | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-10-09 |
| 1497352736 | Gaelle A Wagnac | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-10-08 |
| 1679170153 | Melissa Chenard | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-10-07 |
| 1174137665 | Stacey Marie Anzalone | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-09-02 |
| 1801409511 | Devin Green | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-08-24 |
| 1891306643 | Theresa Goretti | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-08-14 |
| 1306467972 | Aishetu Kutigi Abubakar | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-05-05 |
| 1508487505 | Jennifer Gonzalez | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427515923 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 173 Oxford Street, Lowel Level, Suite P, Lynn, MA 01901 | 2019-02-21 |
| 1730680125 | Sarah Sawulski | Registered Nurse | 269 Union Stree01901t, Lynn, MA 01901 | 2018-02-22 |
| 1184142895 | Adrienne Wood | Case Manager/Care Coordinator | 100 Willow Street, Lynn, MA 01901 | 2017-09-01 |
| 1831613199 | Marie Linda Yannaco-grant | Social Worker | 62 Market Street, Lynn, MA 01901 | 2017-07-28 |
| 1942723457 | Michael Xinyu Miao | Physical Therapy Assistant | 1 Market Street, 3rd Floor, Lynn, MA 01901 | 2017-07-18 |
| 1730544743 | Pediatric Dental Professionals LLC | Dentist | 391 Lynn Way, Bldg A, Lynn, MA 01901 | 2015-12-17 |
| 1346667748 | Emily G. Joseph | Social Worker | 112 Market Street, 2nd Floor, Lynn, MA 01901 | 2014-03-24 |
| 1548510621 | Serena M Smith | Counselor | 181 Union Street, Suite J, Lynn, MA 01901 | 2012-09-14 |
| 1043575624 | Timothy J Bossie | Optometrist | 20 Central Avenue, Lynn, MA 01901 | 2012-07-10 |
| 1689946923 | Lynn Dental Center | Dentist | 232 Union Street, Lynn, MA 01901 | 2012-02-02 |
| Find all providers in zip 01901 | ||||
| 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 |
|---|---|---|---|---|
| 1326551904 | Muthsous Marcel | Family Medicine | 20 Central Ave Fl 4, Lynn, MA 01901-1201 | 2017-11-06 |
| 1558872895 | Congenial Healthcare, LLC | Family Medicine | 330 Lynnway Ste 190a, Lynn, MA 01901-1706 | 2017-10-13 |
| 1285709501 | Michael D Schrenko | Family Medicine | 49 Ocean St, Lynn, MA 01902-2024 | 2006-11-21 |
| 1669459723 | Joseph P. Rafferty Jr. | Family Medicine | Ge Medical Center Building 44, 1000 Western Avenue, Lynn, MA 01910 | 2005-12-29 |
| 1760994016 | Daniela Pineda Ramirez | Family Medicine | 269 Union St, Lynn, MA 01901-1314 | 2017-10-26 |
| 1851813034 | David W. Douglas, Md | Family Medicine | 330 Lynnway Ste 109a, Lynn, MA 01901-1713 | 2017-07-10 |
| 1578904918 | Sara Nakhal | Family Medicine | 269 Union St, Lynn, MA 01901-1314 | 2013-07-15 |
| 1023459419 | Sarwada Tuladhar Jha | Family Medicine | 269 Union St, Lynn, MA 01901-1314 | 2013-07-12 |
| 1528407350 | Elise Bognanno | Family Medicine | 269 Union St, Lynn, MA 01901-1314 | 2013-06-14 |
| 1487091690 | Catherine Reyes | Family Medicine | 269 Union St, Lynn, MA 01901-1314 | 2013-05-29 |
| Find all providers in LYNN | ||||
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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.