DR. HOLLY CLARK (NPI# 1376639047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376639047 |
| Entity Type | Individual |
| Full Name | DR. HOLLY CLARK |
| Credential | M.D. |
| Practice Address |
1250 E 3900 S Suite 360 Salt Lake City UT 84124-1348 |
| Mailing Address |
6360 S 3000 E #220 Salt Lake City UT 84121-6923 |
| Practice Telephone | 8012633041 |
| Practice Fax Number | 8012638485 |
| Mailing Telephone | 8012633041 |
| Mailing Fax Number | 8012638485 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2015-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
4977163 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | VALUE CARE | 49771631200001 | 01 |
| UT | PUBLIC EMPLOYEES | 78498 | 01 |
| UT | BLUE CROSS BLUE SHIELD | 49771631200001 | 01 |
| UT | ALTIUS | QM0000217387 | 01 |
| UT | HEALTHWISE | 49771631200001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962667816 | Holly Ann Clark | Physical Therapist | 5300 Northgate Dr, Bethlehem, PA 18017-9436 | 2008-07-21 |
| 1629256185 | Holly Ann Clark | Counselor | 220 E First Ave Extension, Lexington, NC 27292 | 2008-02-07 |
| 1205823093 | Holly A Clark | Nurse Practitioner | 2320 High St, Blue Island, IL 60406-2426 | 2005-10-05 |
| 1437623980 | Holly Clark | Student in an Organized Health Care Education/Training Program | 2316 Walker Building, Auburn University, AL 36849-0001 | 2019-01-17 |
| 1538630223 | Holly Lyn Clark | Developmental Therapist | 345 Greenwood St Ste A, Worcester, MA 01607-1767 | 2018-12-06 |
| 1427539568 | Holly Clark | Pharmacist | 110 S 9th Ave, Yakima, WA 98902-3315 | 2018-08-27 |
| 1750732285 | Holly Marie Clark | Dentist | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2016-06-27 |
| 1689807349 | Holly D. Clark | Case Manager/Care Coordinator | 2100 Comer Ave, Columbus, GA 31904-8725 | 2009-08-28 |
| 1447409446 | Holly Heist Meskimen Clark | Physician Assistant | 115 Sunnyside Ave, Granger, WA 98932 | 2008-09-15 |
| 1346453727 | Holly Michelle Clark | Psychiatry & Neurology | 410 University Parkway, Suite 2300, Aiken, SC 29801-6807 | 2007-05-08 |
| Street Address |
1250 E 3900 S SUITE 360 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84124-1348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275530305 | Camille Collett | Family Medicine | 1250 E 3900 S, Suite 260, Salt Lake City, UT 84124-1348 | 2005-07-05 |
| 1548795792 | Cammey Young | Family Medicine | 1250 E 3900 S, Suite 260, Salt Lake City, UT 84124-1348 | 2017-04-25 |
| 1285167015 | Danielle Williamson Lin | Student in an Organized Health Care Education/Training Program | 1250 E 3900 S, 260, Salt Lake City, UT 84124-1348 | 2017-04-08 |
| 1609308717 | Brian Christopher Johnson | Family Medicine | 1250 E 3900 S, Suite 260, Salt Lake City, UT 84124-1348 | 2017-03-29 |
| 1144776089 | Rosemarie Linsler | Nurse Practitioner | 1250 E 3900 S, #260, Salt Lake City, UT 84124-1348 | 2016-08-31 |
| 1104289487 | Alec Kitch | Family Medicine | 1250 E 3900 S, Suite #260 Br, Salt Lake City, UT 84124-1348 | 2016-04-03 |
| 1538522461 | Ian Michael Mcdaniels | Family Medicine | 1250 E 3900 S, Suite 260, Salt Lake City, UT 84124-1348 | 2016-03-29 |
| 1891151668 | Abby N Crume Do PC | Colon & Rectal Surgery | 1250 E 3900 S, Ste 320, Salt Lake City, UT 84124-1348 | 2016-01-11 |
| 1679955017 | Summit Oral & Maxillofacial Surgery | Dentist | 1250 E 3900 S, Ste 210, Salt Lake City, UT 84124-1348 | 2015-06-22 |
| 1447667217 | Granger Medical Clinic, Inc. | Clinic/Center | 1250 E 3900 S, Suite 250, Salt Lake City, UT 84124-1348 | 2014-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
| 1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
| 1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
| 1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
| 1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
| 1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
| 1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
| 1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
| 1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| Find all providers in zip 84124 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568592590 | Ihc Health Services Inc | Internal Medicine | 374 10th Ave, Suite 100, Salt Lake City, UT 84103-2823 | 2007-03-07 |
| 1306925433 | Robert F Miller | Internal Medicine | 1002 East South Temple, Ste 412, Salt Lake City, UT 84102 | 2006-11-02 |
| 1033209622 | Randall W. Burt | Internal Medicine | Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112 | 2006-10-13 |
| 1871689562 | Utah Gastroenterology P C | Internal Medicine | 1187 E 3900 S, Salt Lake City, UT 84124-1201 | 2006-10-04 |
| 1972510717 | Utah Gastroenterology P C | Internal Medicine | 6360 South 3000 East, Suite 310, Salt Lake City, UT 84121 | 2006-08-02 |
| 1184655128 | Mae Foung Go | Internal Medicine | 500 Foothill Blvd # 111g, Va Slc Health Care System, Salt Lake City, UT 84148-0001 | 2006-07-06 |
| 1982145181 | Benjamin Hewitt | Internal Medicine | 30 N 1900 E Rm 4r118, Salt Lake City, UT 84132-0002 | 2017-03-20 |
| 1154784783 | Andrew Khoi Nguyen | Internal Medicine | 30 N 1900 E Rm 4r118, Salt Lake City, UT 84132-0002 | 2016-03-31 |
| 1245634047 | University of Utah Adult Services | Internal Medicine | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2014-10-22 |
| 1972921658 | Malan Tara Shiralkar | Internal Medicine | 50 N Medical Dr, Salt Lake City, UT 84132-7232 | 2014-03-31 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
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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.