CRYSTAL CLARK


Address: 153 Brambury Dr Apt D, Rochester, NY 14621-1820
Phone: 4046212852

CRYSTAL CLARK (NPI# 1467014894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467014894
Entity Type Individual
Full Name CRYSTAL CLARK
Practice Address 153 Brambury Dr Apt D
Rochester
NY 14621-1820
Mailing Address Po Box 64283
Rochester
NY 14624-6683
Practice Telephone 4046212852
Mailing Telephone 4043212852
Enumeration Date 2019-07-06
Last Update Date 2019-07-06
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 372500000X Chore Provider Nursing Service Related Providers
Y 372600000X Adult Companion Nursing Service Related Providers
N 376K00000X Nurse's Aide NYGA0401903R NY Nursing Service Related Providers

Other Providers CRYSTAL CLARK

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1619581311 Crystal Clark Massage Therapist 12506 Ne 4th Ave Apt 101, North Miami, FL 33161-4668 2020-09-01
1366068470 Crystal Sherase Clark Technician 4429 Grant St Ne, Washington, DC 20019-4739 2020-06-24
1386112050 Crystal Lynn Clark Internal Medicine 12056 224th St, Cambria Heights, NY 11411-2141 2018-11-11
1154898179 Crystal B Clark Family Medicine 112 Woodland Drive, Lancaster, SC 29720 2018-10-29
1801259619 Crystal Clark Technician, Other 3400 State St # 750, Salem, OR 97301-5861 2016-03-30
1467829911 Crystal Lynn Clark Specialist/Technologist 1500 Manley St, Dalton High School, Dalton, GA 30720-4088 2015-08-31
1386073070 Crystal Shawn Clark Nurse Anesthetist, Certified Registered 240 W Sugar Loaf Rd, Tucson, AZ 85737-3756 2013-11-04
1417391160 Crystal Joan Clark Nurse Practitioner 11930 Arbor St Ste 200, Omaha, NE 68144-2998 2013-04-24
1952677700 Crystal Nache Clark Counselor 13902 Sage Thrasher Lane, Riverview, FL 33579 2012-03-27
1639443658 Crystal A Clark Chore Provider 331 Jamestown Ct, Columbus, OH 43228-4030 2012-03-08

Office Location

Street Address 153 BRAMBURY DR APT D
City ROCHESTER
State NY
Zip Code 14621-1820

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619515327 Patti Humphrey Occupational Therapist 1831 Ridge Rd. East, Rochester, NY 14621 2019-12-12
1861956682 Sonya Thomas Counselor Sonya Thomas, 490 East Ridge Road, Rochester, NY 14621 2019-01-25
1811478357 Laura Iannella Student in an Organized Health Care Education/Training Program 1455 East Ridge, Rochester, NY 14621 2018-08-23
1982180345 Naman Sharma Student in an Organized Health Care Education/Training Program Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621 2018-07-18
1699213447 Kara Mcallister Nurse Practitioner 370 East Ridge Road, Suite 400, Rochester, NY 14621 2017-02-01
1285082982 Universal Care Services, LLC In Home Supportive Care 64 Delamaine Drive, Rochester, NY 14621 2016-06-03
1700243896 Kenroy King I Registered Nurse 67 Warsaw Street, Rochester, NY 14621 2016-01-21
1154794808 Shari Venisee Licensed Practical Nurse 67 Carthage St, Rochester, NY 14621 2015-11-03
1114349024 Anthony Michael Plavsity Registered Nurse 1450 Clifford Ave, Rochester, NY 14621 2014-01-11
1033541107 The Community Place of Greater Rochester, Inc Case Management 500 Carter Street, Rochester, NY 14621 2013-07-31
Find all providers in zip 14621

Taxonomy Information

Taxonomy Code 372600000X
Grouping Nursing Service Related Providers
Classification Adult Companion

Taxonomy Definition

An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134786130 Mohamed Shido Hassan Adult Companion 1312 7th St Nw Ste 203, Rochester, MN 55901-1704 2019-05-24
1255874400 Robin Douglas Brown Adult Companion 507 Wegman Rd, Rochester, NY 14624-1423 2016-11-21
1003862590 Pelpari Corp Adult Companion 1577 Ridge Rd West, Suite 205, Rochester, NY 14615-2511 2006-05-26
1609363787 Jeffery Mclamore Jr. Adult Companion 64 Lozier St, Rochester, NY 14611-2520 2018-04-15

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1467051193 Karin M Caro Adult Companion 9 Three Pond Road, Smithtown, NY 11787 2020-10-23
1093313991 Skynet Home Care Agency Inc Adult Companion 775 Concourse Vlg E Apt 4d, Bronx, NY 10451-3939 2020-10-13
1831796531 Alisha Christine Wright Adult Companion 142 Saint Louis Ave, Syracuse, NY 13207-2247 2020-10-06
1518575125 Jofef Companion Care Inc Adult Companion 10522 Jamaica Ave, Richmond Hill, NY 11418-2013 2020-07-20
1336762517 Ellmak Inc Adult Companion 1889 Randall Ave, Bronx, NY 10473-2933 2020-05-22
1528680147 Angel Rose Care Services, Inc. Adult Companion 129 Moore Ave, Freeport, NY 11520-1418 2020-05-18
1720613920 Kovette Thorpe Adult Companion 22 Montgomery St Apt 10d, Poughkeepsie, NY 12601-4021 2020-03-08
1659902252 Rose Kadosh Adult Companion 8210 19th Ave Apt B3, Brooklyn, NY 11214-2329 2020-02-01
1316577984 Shanalee Henry Gordon Adult Companion 205 South Ave Ste 108, Poughkeepsie, NY 12601-4823 2020-01-22
1215567482 Jason Debenedictis Adult Companion 23 Singingwood Dr, Holbrook, NY 11741-2818 2020-01-16
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Competitor

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City ROCHESTER
Zip Code 14621

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Dataset Information

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.

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