CASEY DANIEL CLARK (NPI# 1225542558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225542558 |
| Entity Type | Individual |
| Full Name | CASEY DANIEL CLARK |
| Credential | NP |
| Practice Address |
230 Sheraton Blvd Macon GA 31210-1358 |
| Practice Telephone | 4784742947 |
| Practice Fax Number | 4789718149 |
| Mailing Telephone | 4784742947 |
| Mailing Fax Number | 4789718149 |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2017-11-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN214247 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841853694 | Casey Clark | Student in an Organized Health Care Education/Training Program | 2213 Cherry Street, Ambulatory Care Center 1st Floor, Toledo, OH 43608 | 2019-04-17 |
| 1174534085 | Casey Ryan Clark | Nurse Anesthetist, Certified Registered | 22234 Kennemer Ln, Athens, AL 35613-8162 | 2006-08-10 |
| 1306340286 | Casey Lane Clark | Student in an Organized Health Care Education/Training Program | 900 S Limestone Ctw 304, Lexington, KY 40536-0001 | 2018-03-23 |
| 1477072809 | Casey Morgan Clark | Behavior Technician | 2101 Arc Dr, St Augustine, FL 32084-0512 | 2017-09-18 |
| 1518308923 | Casey Clark | Registered Nurse | 815 Oberlin Rd, Raleigh, NC 27605-1300 | 2013-07-13 |
| 1184929648 | Casey M Clark | Physical Therapist | 100 Park St, Glens Falls, NY 12801-4413 | 2011-01-14 |
| 1174528871 | Casey J. Clark | Physical Therapist | 2170 S Lamar Blvd, Oxford, MS 38655-5224 | 2005-06-17 |
| Street Address |
230 SHERATON BLVD |
| City | MACON |
| State | GA |
| Zip Code | 31210-1358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396141545 | Axis Surgery Center LLC | Clinic/Center | 230 Sheraton Blvd, Ste B, Macon, GA 31210 | 2014-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1871124735 | Jessica Bello | Nurse Practitioner | 5300 Bowman Road, Macon, GA 31210 | 2020-01-30 |
| 1225505787 | Rebekah Hollinshead | Occupational Therapist | Therapy Specialists of Georgia, 4116 Arkwright Road, Macon, GA 31210 | 2018-11-01 |
| 1346744943 | Ace Medical Transport LLC. | Ambulance | 728 Gay Dr, Macon, GA 31210 | 2018-03-20 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1083074868 | Macon Dentist Office, PC | Dentist | 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 | 2016-03-07 |
| 1992176952 | Kerisia Wasztyl | Marriage & Family Therapist | 4691 Pine Valley Dr, Macon, GA 31210 | 2015-10-15 |
| 1073905444 | Eunice Malave De Leon | Social Worker | 174 Spring St, Macon, GA 31210 | 2015-02-23 |
| 1073914115 | Monique Rechelle Delay Moore | Community/Behavioral Health | 646 Millrun Court, Macon, GA 31210 | 2014-09-09 |
| 1134568777 | John Norman Bowman Sr. | Dentist | 760 Tufthunter, Macon, GA 31210 | 2013-06-17 |
| Find all providers in zip 31210 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821604158 | Tekeria Gallemore | Nurse Practitioner | 204 Rockingham Pl, Macon, GA 31217-2615 | 2020-09-22 |
| 1710534839 | Tuwanna Yvette Brooks | Nurse Practitioner | 2685 Cherokee Ave, Macon, GA 31204-3940 | 2019-08-22 |
| 1568019206 | Candace W Webb | Nurse Practitioner | 770 Pine St Ste 310, Macon, GA 31201-7587 | 2019-08-19 |
| 1013579846 | Rachel Michelle Applegate | Nurse Practitioner | 657 Hemlock St Ste 200, Macon, GA 31201-8324 | 2019-07-02 |
| 1447813993 | Amelia Angelica Harpe Mills | Nurse Practitioner | 3300 N Ingle Pl Apt 6e, Macon, GA 31210-2529 | 2019-04-19 |
| 1922563287 | Vanessa Lott | Nurse Practitioner | 107 William Way, Macon, GA 31216-6160 | 2019-01-31 |
| 1649771155 | Tory Kirsten Etheridge | Nurse Practitioner | 688 Walnut St Ste 200, Macon, GA 31201-0333 | 2018-02-21 |
| 1003324112 | Jared L Jarrett Np, LLC | Nurse Practitioner | 770 Pine St Ste 560, Macon, GA 31201-7569 | 2018-01-11 |
| 1699281360 | Charneika C Brown | Nurse Practitioner | 639 Hemlock St Ste 100, Macon, GA 31201-6889 | 2017-12-18 |
| 1821512393 | Bridgette Rebecca Harrison | Nurse Practitioner | 193 John Michael Drive, Macon, GA 31211 | 2017-07-27 |
| Find all providers in MACON | ||||
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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.