CRYSTAL CLARK (NPI# 1467014894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
Street Address |
153 BRAMBURY DR APT D |
City | ROCHESTER |
State | NY |
Zip Code | 14621-1820 |
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 Code | 372600000X |
Grouping | Nursing Service Related Providers |
Classification | Adult Companion |
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] |
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 |
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 |
Find all providers with the same taxonomy |
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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.