SCOTT CLARK (NPI# 1255440475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255440475 |
| Entity Type | Individual |
| Full Name | SCOTT CLARK |
| Credential | PA |
| Practice Address |
1503 Buenos Aires Blvd Ste 100 The Villages FL 32159-6825 |
| Mailing Address |
151 Southhall Ln Ste 300 Maitland FL 32751-7172 |
| Practice Telephone | 3527532812 |
| Practice Fax Number | 3527530537 |
| Mailing Telephone | (407) 875-2080 |
| Mailing Fax Number | 4076503455 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA3724 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 300867600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 600 W Plymouth Ave, Deland, FL 327203260 | 3867388000 | 3867380929 |
| 1816 Salk Ave, Tavares, FL 327784300 | 3523432461 | 3523435968 |
| 2893 Enterprise Rd Ste 100, Debary, FL 327132784 | 3867898600 | 3867890219 |
| 1918 Se 17th St # 300, Ocala, FL 344714120 | 3526202420 | 3526202935 |
| 725 W Granada Blvd Ste 44, Ormond Beach, FL 321749406 | 3868980547 | 3868980551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275650657 | Scott C Clark | Chiropractor | 1540 N Arlington Heights Rd, Arlington Heights, IL 60004-3906 | 2007-03-23 |
| 1205903754 | Scott Clark | Optometrist | 491 Rantoul St, Beverly, MA 01915-3231 | 2006-11-29 |
| 1225119191 | Scott Earl Clark | Physician Assistant | 6 Fountain Plaza, Buffalo, NY 14202 | 2006-10-18 |
| 1265490734 | Scott Matthew Clark | Chiropractor | 8000 Dallas St, Fort Smith, AR 72903-4277 | 2006-05-03 |
| 1700865748 | Scott A Clark | Podiatrist | 24 S 1100 E Ste 210, Salt Lake City, UT 84102 | 2006-01-10 |
| 1336752286 | Scott Clark | Behavior Technician | 5457 Sw Canyon Ct, Portland, OR 97221-2401 | 2020-08-28 |
| 1518528868 | Scott Randall Clark | Nurse Practitioner | 809 W Randol Mill Rd, Arlington, TX 76012-2507 | 2019-06-27 |
| 1487163002 | Scott Thomas Clark | Counselor | 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2017-09-26 |
| 1710432984 | Scott Clark | Pharmacist | 100 W Riverside Dr, Parker, AZ 85344-5205 | 2016-08-17 |
| 1316331994 | Scott Clark Jr. | Registered Nurse | 2250 Wehrle Dr, Suite 1, Williamsville, NY 14221-7034 | 2015-03-23 |
| Street Address |
1503 BUENOS AIRES BLVD STE 100 |
| City | THE VILLAGES |
| State | FL |
| Zip Code | 32159-6825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306451216 | Lindsey Porubcan | Physician Assistant | 990 South Us Highway 441/27, Lady Lake, FL 32159 | 2020-09-09 |
| 1073134979 | Michael Robert Frates | Dietitian, Registered | 900 Cr 466, Lady Lake, FL 32159 | 2020-05-01 |
| 1346800364 | Barbara Conrad | Social Worker | 906 Orchid Street, Lady Lake, FL 32159 | 2019-06-20 |
| 1962977165 | Curelogics Wound Care and Hyperbaric LLC | Registered Nurse | 809 County Road 466, Unit C-201, Lady Lake, FL 32159 | 2018-10-04 |
| 1346736907 | Caroline Butler | Physician Assistant | 805 E. Cr 466, Lady Lake, FL 32159 | 2018-07-06 |
| 1033609607 | Cyrus Immanuel Macalisang Doroy | Physical Therapist | 6340 County Rd 466, Suite 733, Lady Lake, FL 32159 | 2018-05-18 |
| 1962999680 | Sharma Institute of Pain Medicine | Physical Medicine & Rehabilitation | 1501 Us Hwy 441, Villages, FL 32159 | 2018-04-18 |
| 1538683198 | Cathleen Laurel Civiello | Psychologist | 929 H. Hwy 441, Suite 404, Lady Lake, FL 32159 | 2017-07-26 |
| 1649709015 | Adria Young | Optometrist | 801 Cr 466, Suite 102 Sunset Plaza, Lady Lake, FL 32159 | 2017-06-08 |
| 1891222527 | Center for Hope and Healing, LLC | Social Worker | 804 Hwy 466, Lady Lake, FL 32159 | 2017-05-12 |
| Find all providers in zip 32159 | ||||
| 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 |
|---|---|---|---|---|
| 1386949733 | Jennifer Anne West | Physician Assistant | 352 East Cr 466, The Villages, FL 32159-4205 | 2011-01-17 |
| 1790976330 | Jennifer Starr Davis | Physician Assistant | 340 Heald Way Ste 216, The Villages, FL 32163-6088 | 2007-08-08 |
| 1275636128 | Philomena Walker | Physician Assistant | 1950 Laurel Manor Dr Ste 224, The Villages, FL 32162-5602 | 2006-09-06 |
| 1346891942 | Brian Paul Wisowaty | Physician Assistant | 1400 N Us Highway 441 Ste 810, The Villages, FL 32159-8987 | 2019-09-25 |
| 1639722887 | Troy Edward Black Pace | Physician Assistant | 2910 Brownwood Blvd, The Villages, FL 32163-2032 | 2019-07-17 |
| 1376195677 | Katherine Rodriguez | Physician Assistant | 1050 Old Camp Rd Ste 100, The Villages, FL 32162-1762 | 2019-07-16 |
| 1104485291 | Amanda Naumann | Physician Assistant | 1050 Old Camp Rd Ste 100, The Villages, FL 32162-1762 | 2019-06-11 |
| 1861951246 | Sarah Marie Ely | Physician Assistant | 1580 Santa Barbara Blvd, The Villages, FL 32159-6827 | 2019-03-15 |
| 1083183826 | Sierra C Heptner | Physician Assistant | 1575 Santa Barbara Blvd, The Villages, FL 32159-6820 | 2018-11-23 |
| 1528541166 | Sara Michele Rojek | Physician Assistant | 1503 Buenos Aires Blvd, The Villages, FL 32159-6821 | 2018-09-10 |
| Find all providers in THE VILLAGES | ||||
| City | THE VILLAGES |
| Zip Code | 32159 |
Please comment or provide details below to improve the information on SCOTT 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.