SHAE CLARK (NPI# 1114536323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114536323 |
| Entity Type | Individual |
| Full Name | SHAE CLARK |
| Practice Address |
4900 Mueller Blvd Ste 3s.003 Austin TX 78723-3079 |
| Mailing Address |
324 Palo Alto Way Austin TX 78732-2453 |
| Practice Telephone | 5123243600 |
| Mailing Telephone | 2107898170 |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0222X |
Nurse Practitioner Specialization: Pediatrics, Critical Care |
1005225 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4900 MUELLER BLVD STE 3S.003 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78723-3079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003132192 | Sara E Mendoza Crespo | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4900 Mueller Blvd Ste 3s.003, Austin, TX 78723-3079 | 2010-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144787318 | Bridget Wilson | Counselor | 6448 East Hwy 290, Suite F108, Austin, TX 78723 | 2019-02-25 |
| 1700378999 | Andrew Christopher Shanks | Counselor | 2132 Antone St, Austin, TX 78723 | 2018-06-04 |
| 1316434236 | Yasaman Ahmadieh | Pediatrics | 4900 Mueller Boulevard, Suite 3s.066c, Austin, TX 78723 | 2018-04-16 |
| 1215433354 | Erika Senai Ramirez | Nurse Practitioner | 6900 Ed Bluestein Blvd, Austin, TX 78723 | 2018-04-05 |
| 1518477645 | Brigitte Tyree | Registered Nurse | 2237 Zach Scott St, Austin, TX 78723 | 2017-10-03 |
| 1942735980 | Ila Sehgal | Pediatrics | 4900 Mueller Blvd, Ste 3s.066c, Dell Children's Medical Center, Austin, TX 78723 | 2017-04-27 |
| 1851825194 | Terry Blackmon | Behavioral Analyst | 2021 Zach Scott St, Austin, TX 78723 | 2017-04-13 |
| 1114337961 | Cassandra Sorensen | Home Health | 3001 Maplelawn Circle, Austin, TX 78723 | 2014-05-02 |
| 1336569052 | Ricky C Mehta | Internal Medicine | 6210 E Hwy 290 Ste 420, Austin, TX 78723 | 2014-04-21 |
| 1356761373 | Peter Caldwell Gilbreath | Pediatrics | 4900 Mueller Boulevard, Suite 3s.066c, Dell Children's Medical Center, Austin, TX 78723 | 2014-04-17 |
| Find all providers in zip 78723 | ||||
| Taxonomy Code | 363LP0222X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417594102 | Rebecca J Blackwell | Nurse Practitioner | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2019-12-02 |
| 1861037038 | Rachel Annette Cano Brendlinger | Nurse Practitioner | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2019-11-12 |
| 1164065983 | Michelle Jenise Gibson | Nurse Practitioner | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2019-10-24 |
| 1518402361 | Hannah Noori | Nurse Practitioner | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2017-01-04 |
| 1285078873 | Jennifer Joyner | Nurse Practitioner | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2013-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205474582 | Jill Yvonne Steinbach | Nurse Practitioner | 1216 Oakwood Ct, Flower Mound, TX 75028-3689 | 2019-12-17 |
| 1215426531 | Nathan Lee Haupt | Nurse Practitioner | 11709 Hamptonbrook Dr, Mckinney, TX 75071-6359 | 2018-05-02 |
| 1568992667 | Kathy Lou Drescher | Nurse Practitioner | 7777 Forest Lane, Mcch 100, Dallas, TX 77230 | 2017-06-13 |
| 1194262279 | Brandi Lea Crump | Nurse Practitioner | 8136 Mountain Cedar Dr, Fort Worth, TX 76131-3592 | 2017-01-26 |
| 1003996414 | Patricia Oakland | Nurse Practitioner | 6621 Fannin St # Wt6-006, Houston, TX 77030-2303 | 2006-10-17 |
| 1669561924 | Tammy Suzanne Robertson | Nurse Practitioner | 3605 Banks Cir, Plano, TX 75025-3849 | 2006-10-12 |
| 1912958315 | Maria S Chico | Nurse Practitioner | 1935 Medical District Dr - Mail: D10301.a, Children's Medical Center, Dallas, TX 75235-7701 | 2006-05-12 |
| 1437759842 | Kira Ann Snyder | Nurse Practitioner | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2020-10-27 |
| 1285242933 | Stephanie Lynn Spencer | Nurse Practitioner | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2020-07-20 |
| 1295357465 | Aivy Nguyen | Nurse Practitioner | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2020-05-11 |
| 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.