NICOLE M CLARK (NPI# 1114164142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114164142 |
| Entity Type | Individual |
| Full Name | NICOLE M CLARK |
| Credential | PA-C |
| Practice Address |
595 Newberry Hwy Saluda SC 29138-7808 |
| Practice Telephone | 8644452500 |
| Practice Fax Number | 8644453956 |
| Mailing Telephone | 8644452500 |
| Mailing Fax Number | 8644453956 |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2017-05-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2017 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 1932PA | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344826 | Nicole Clark | Home Health Aide | 1024 E 26th Ave, Columbus, OH 43211-2127 | 2020-10-26 |
| 1386106375 | Nicole Clark | Prosthetist | 100 N Burke Ave, Long Beach, MS 39560-4605 | 2019-04-01 |
| 1023513637 | Nicole Elizabeth Clark | Counselor | 3650 Ne Mallory Ave Apt 309, Portland, OR 97212-3086 | 2018-03-26 |
| 1619486834 | Nicole Clark | Registered Nurse | N4093 Keehn Rd, Winter, WI 54896-7312 | 2017-09-20 |
| 1285182022 | Nicole Michelle Clark | Social Worker | 1349 East Stroop Road, Dayton, OH 45429-4925 | 2016-09-21 |
| 1871968768 | Nicole Clark | Specialist/Technologist | 332 Wilson Dr, Bloomfield, IN 47424-1054 | 2015-12-03 |
| 1598165144 | Nicole Janine Clark | Behavioral Analyst | 1787 Village Ln N, Wantagh, NY 11793-3228 | 2014-09-02 |
| 1841609484 | Nicole Tm Clark | Emergency Medicine | 267 Ocean Ave, Portland, ME 04103-5707 | 2014-08-07 |
| 1851445670 | Nicole Ann Clark | Social Worker | 2051 S State St, Ann Arbor, MI 48104-4607 | 2007-01-22 |
| 1982767604 | Nicole Christine Clark | Licensed Practical Nurse | 241 Lorraine Ave, Syracuse, NY 13210-3229 | 2006-12-18 |
| Street Address |
595 NEWBERRY HWY |
| City | SALUDA |
| State | SC |
| Zip Code | 29138-7808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861472490 | Ralph N Riley | Family Medicine | 595 Newberry Hwy, Saluda, SC 29138-7808 | 2006-01-19 |
| 1265971030 | Self Medical Group | Family Medicine | 595 Newberry Hwy, Saluda, SC 29138-7808 | 2017-02-14 |
| 1124423561 | David I Stevens | Physician Assistant | 595 Newberry Hwy, Saluda, SC 29138-7808 | 2014-10-28 |
| 1891123659 | Keyonia Young Johnson | Nurse Practitioner | 595 Newberry Hwy, Saluda, SC 29138-7808 | 2013-10-14 |
| 1588945141 | Providence Cardiology LLC | Internal Medicine | 595 Newberry Hwy, Saluda, SC 29138-7808 | 2011-09-08 |
| 1366677106 | South Carolina Heart Center Pa | Internal Medicine | 595 Newberry Hwy, Saluda, SC 29138-7808 | 2009-05-22 |
| 1104970847 | Riley Family Practice Associates Pa | Clinic/Center | 595 Newberry Hwy, Saluda, SC 29138 | 2007-01-22 |
| 1629087481 | Julie G Boggs | Nurse Practitioner | 595 Newberry Hwy, Saluda, SC 29138-7808 | 2006-08-07 |
| 1659335446 | Diane E Stribling | Nurse Practitioner | 595 Newberry Hwy, Saluda, SC 29138-7808 | 2006-04-17 |
| 1992769665 | Riley Family Practice Associates Pa | Family Medicine | 595 Newberry Hwy, Saluda, SC 29138-7808 | 2006-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578028791 | Brandi Hallman | Registered Nurse | 300 Matthews Drive, Saluda, SC 29138 | 2019-02-01 |
| 1891170056 | County of Saluda | Ambulance | 154 Medical Park Rd, Saluda, SC 29138 | 2015-07-29 |
| 1861742215 | Taylor Whittle Floyd | Pharmacist | 321 North Main Street, Saluda, SC 29138 | 2012-09-13 |
| 1568592681 | Saluda Nursing Center | Ambulance | 581 Newberry Highway, Saluda, SC 29138 | 2007-03-07 |
| 1497830996 | Rufus B. Antley, O.d. | Optometrist | 108-a N. Jennings St., Saluda, SC 29138 | 2006-10-25 |
| 1033227566 | Samuel Fair Wheeler | Dentist | 201 N Banks St, Saluda, SC 29138 | 2006-08-25 |
| 1295768083 | Gina Thompson Fingerlin | Registered Nurse | 140 Ivory Key Rd, Saluda School District, Saluda, SC 29138 | 2006-07-08 |
| 1962433052 | Peoples Drug Co LLC | Pharmacy | 301 W Butler Ave, Saluda, SC 29138 | 2006-07-06 |
| 1073598447 | Saluda Family Medicine Pa | Family Medicine | 102 Rl Sawyer Md Drive, Saluda, SC 29138 | 2005-12-08 |
| 1427435726 | Juliana Atkins | Family Medicine | 102 R L Sawyer Md Dr, Saluda, SC 29138 | 2015-05-06 |
| Find all providers in zip 29138 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124423561 | David I Stevens | Physician Assistant | 595 Newberry Hwy, Saluda, SC 29138-7808 | 2014-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770712 | Hannah Jenkins | Physician Assistant | 780 Windrow Dr, Sumter, SC 29150-5318 | 2020-11-04 |
| 1255931283 | Sterling Simmons Capotosti | Physician Assistant | 1813 Joseph Cir, Florence, SC 29501-6339 | 2020-10-28 |
| 1538768098 | Hristos Stamatopoulos | Physician Assistant | 149 Independent Ln, Walterboro, SC 29488-6218 | 2020-10-25 |
| 1053910596 | Sarah Xiao Jing Jarema | Physician Assistant | 1211 Hadley Cir Unit 4301, Myrtle Beach, SC 29577-8219 | 2020-10-24 |
| 1063011062 | Sara Chmielewski | Physician Assistant | 283 Blvd De France, Parris Island, SC 29905 | 2020-10-21 |
| 1487252367 | Hannah Beddingfield | Physician Assistant | 200 Drury Ln, Mauldin, SC 29662-2228 | 2020-10-13 |
| 1275131054 | Ethan Brody Clontz | Physician Assistant | 1953 Pinehurst Ave, Charleston, SC 29414-6483 | 2020-10-13 |
| 1790383719 | Kaytlin Blake Hollingsworth | Physician Assistant | 2774 Shadow Ln, North Charleston, SC 29406-9065 | 2020-10-12 |
| 1487261509 | Reilly Kilpatrick | Physician Assistant | 1518 Blaze Ln, Charleston, SC 29412-8652 | 2020-09-24 |
| 1144836461 | Michael Joseph Haven | Physician Assistant | 221 Bayfront Dr Unit 224, Mount Pleasant, SC 29464-1825 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on NICOLE M 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.