DR. JOHNATHAN CLARK (NPI# 1538532361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538532361 |
| Entity Type | Individual |
| Full Name | DR. JOHNATHAN CLARK |
| Credential | D.C. |
| Practice Address |
542 S State St Sparta MI 49345-1547 |
| Practice Telephone | 6168872178 |
| Mailing Telephone | 6168872178 |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2019-11-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | DC011132 | PA | Chiropractic Providers |
| Y | 111N00000X | Chiropractor | 2301010324 | MI | Chiropractic Providers |
| N | 111N00000X | Chiropractor | 0104557282 | VA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | MEDICARE | 504995ZU84 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740805670 | Johnathan M Clark | Registered Nurse | 6171 W Charleston Blvd, Las Vegas, NV 89146-1126 | 2020-06-16 |
| Street Address |
542 S STATE ST |
| City | SPARTA |
| State | MI |
| Zip Code | 49345-1547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346534039 | Lynnmarie Skipper Leyder | Chiropractor | 542 S State St, Sparta, MI 49345-1547 | 2011-05-31 |
| 1205121472 | Serenity Wellness Plc | Chiropractor | 542 S State St, Sparta, MI 49345-1547 | 2011-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497278105 | Sunkyo Seo | Dentist | 628 Lake Gerald Ct Ne, Sparta, MI 49345 | 2017-07-25 |
| 1811223050 | Freeland Chiropractic Center P.C. | Chiropractor | 200 East Division Street, Sparta, MI 49345 | 2009-10-22 |
| 1306064720 | Intercare Community Health Network | Clinic/Center | 540 South State Street, Sparta, MI 49345 | 2007-04-23 |
| 1861616427 | Ann Elizabeth Fox | Physical Therapist | 31 Ida Red Avenue, Sparta, MI 49345 | 2007-04-12 |
| 1336215953 | George David Freeland | Chiropractor | 200 E Division, Sparta, MI 49345 | 2006-11-27 |
| 1033204557 | Dennis L Radke | Dentist | 72 East Division, Sparta, MI 49345 | 2006-10-03 |
| 1437190469 | John Stephen Lange | Dentist | 62 N Union, Sparta, MI 49345 | 2006-06-09 |
| 1659335172 | Home Town Pharmacy Inc | Pharmacy | 133 E Division, Sparta, MI 49345 | 2006-04-13 |
| 1336260298 | Vorpi Chiropractic Inc | Chiropractor | 9161 Sparta Ave Nw, Suite E, Sparta, MI 49345 | 2007-04-02 |
| 1649300203 | Lori Lynn Vorpi | Chiropractor | 9161 Sparta Ave Nw, Suite E, Sparta, MI 49345 | 2007-03-06 |
| Find all providers in zip 49345 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942709787 | Bernadette Ann Vallorosi | Chiropractor | 53 Sparta Ave, Sparta, NJ 07871-1814 | 2018-02-07 |
| 1558872366 | John Richard Kopp | Chiropractor | 415 W Wisconsin St Ste 4, Sparta, WI 54656-2493 | 2017-10-19 |
| 1578019899 | M&t Performance Chiropractic, LLC | Chiropractor | 213 N Black River St, Sparta, WI 54656 | 2016-08-28 |
| 1407224389 | Chiropractic Health Clinic of Sparta, LLC | Chiropractor | 33 Woodport Rd, Sparta, NJ 07871-2431 | 2015-09-09 |
| 1104161744 | Heath Gilman Foster | Chiropractor | 9 Cook St, Sparta, TN 38583-1570 | 2012-12-09 |
| 1346534039 | Lynnmarie Skipper Leyder | Chiropractor | 542 S State St, Sparta, MI 49345-1547 | 2011-05-31 |
| 1811223050 | Freeland Chiropractic Center P.C. | Chiropractor | 200 East Division Street, Sparta, MI 49345 | 2009-10-22 |
| 1851521421 | Daniel William Scarffe | Chiropractor | 450 S State St, Suite 1, Sparta, MI 49345-1582 | 2009-07-17 |
| 1710176672 | Pine Cone Chiropractic | Chiropractor | 10 Pine Cone Lane, Sparta, NJ 07871-2302 | 2007-10-17 |
| 1831318641 | Robert Duane Klingensmith | Chiropractor | 771 S Main St, Sparta, NC 28675 | 2007-04-24 |
| Find all providers in SPARTA | ||||
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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.