FRED CLARKE (NPI# 1346206950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346206950 |
| Entity Type | Individual |
| Full Name | FRED CLARKE |
| Credential | MD |
| Practice Address |
20016 Hollis Avenue Jamaica NY 11412 |
| Mailing Address |
80 Marcus Dr Provider Enrollment Melville NY 11747-4230 |
| Practice Telephone | 7187368204 |
| Practice Fax Number | 7187368505 |
| Mailing Telephone | 6313917889 |
| Mailing Fax Number | 6314544163 |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2013-01-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 206376 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01862739 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548292428 | Fred Wallace Clarke | Chiropractor | 13849 S Mur Len Rd, Suite E, Olathe, KS 66062-1652 | 2006-07-07 |
| Street Address |
20016 HOLLIS AVENUE |
| City | JAMAICA |
| State | NY |
| Zip Code | 11412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043780901 | Emilsie Guerlaine Leconte | Licensed Practical Nurse | 19216 119th Ave, Saint Albans, NY 11412 | 2018-12-04 |
| 1124535554 | Pamela Ceclia Worrell-springer | Registered Nurse | 188-19 104th Ave, St. Albans, NY 11412 | 2018-01-08 |
| 1639681786 | Dr Bryant Medical Practice PC | Internal Medicine | 20515 Hollis Ave, Saint Albans, NY 11412 | 2017-10-30 |
| 1760907547 | Chudney Desarme | Licensed Practical Nurse | 190-24 111th Ave, Saint Albans, NY 11412 | 2017-08-14 |
| 1194266973 | Samantha Amanda Bailey | Licensed Practical Nurse | 117-35 195th Street, St Albans, NY 11412 | 2017-03-14 |
| 1659826543 | Rachel Colin | Nurse Practitioner | 109-02 201 Street, Jamaica, NY 11412 | 2016-08-20 |
| 1093173387 | Sharon Magwood | Specialist | 189-11 116th. Rd., 2nd. Fl, St.albans, NY 11412 | 2016-02-02 |
| 1790164374 | Wise Pharmacy LLC | Health Maintenance Organization | 189-01 Linden Blvd, Saint Albans, NY 11412 | 2015-05-28 |
| 1366833683 | Gordon's Cognitive Balance Center Inc | Community Health Worker | 113-41 Farmers Blvd, St. Albans, NY 11412 | 2015-02-09 |
| 1225458003 | Natasha Mcmillan | Student in an Organized Health Care Education/Training Program | 187-27 Dunkirk Dr, St. Albans, NY 11412 | 2014-04-21 |
| Find all providers in zip 11412 | ||||
| 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 |
|---|---|---|---|---|
| 1467061143 | Atm Gouse Mohiuddin | Family Medicine | 8900 170th St, Jamaica, NY 11432-5341 | 2020-07-28 |
| 1891254272 | Bari Medical Pllc | Family Medicine | 17016 84th Dr, Jamaica, NY 11432-2109 | 2019-03-15 |
| 1235657925 | Mythily Ramanathan | Family Medicine | 8715 165th St Apt 2d, Jamaica, NY 11432-3513 | 2017-09-02 |
| 1720513427 | St. Sebastian Medical PC | Family Medicine | 16836 Jamaica Ave, Jamaica, NY 11432-5216 | 2017-05-01 |
| 1104161827 | Citywide Medical Care, PC | Family Medicine | 15325 Hillside Ave, Jamaica, NY 11432-3331 | 2012-12-06 |
| 1891926853 | Naznin Khan | Family Medicine | 118-11 Guy R Brewer Blvd, Jamaica, NY 11434-4006 | 2009-08-07 |
| 1457548745 | Pancare Medical PC | Family Medicine | 15915 Hillside Ave, Jamaica, NY 11432-3935 | 2007-10-01 |
| 1023174596 | Patricia Wong Hermogenes | Family Medicine | 13701 83rd Ave, 1b, Jamaica, NY 11435-1562 | 2006-12-29 |
| 1033298906 | Sophia Streete Smalls | Family Medicine | 11513a Merrick Blvd, Jamaica, NY 11434-1851 | 2006-11-03 |
| 1922186782 | Kaniz Fatema Begum | Family Medicine | 137-50 Jamaica Ave, Jamaica, NY 11435-3610 | 2006-11-01 |
| Find all providers in JAMAICA | ||||
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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.