ZACHARY CHARLES CLARK (NPI# 1568025211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568025211 |
| Entity Type | Individual |
| Full Name | ZACHARY CHARLES CLARK |
| Credential | DO |
| Practice Address |
1638 Owen Dr Fayetteville NC 28304-3424 |
| Practice Telephone | 9106155095 |
| Mailing Telephone | 9106155095 |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063049054 | Zachary Kyle Clark | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr Rm 714, Mobile, AL 36617-2300 | 2020-03-27 |
| 1356827844 | Zachary Reilly Clark | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2018-07-17 |
| 1063955318 | Zachary Clark | Occupational Therapist | 555 Anthony Wayne Trl, Waterville, OH 43566-1516 | 2016-11-18 |
| 1790169225 | Zachary Alexander Clark | Massage Therapist | 99-128 Aiea Heights Dr, Suite 207, Aiea, HI 96701-3925 | 2015-07-14 |
| 1023429495 | Zachary Eugene Clark | Radiology | 619 19th St S, Birmingham, AL 35249 | 2014-05-19 |
| 1194098871 | Zachary E Clark | Pharmacist | 444 Pacific Ave S, Monmouth, OR 97361-1543 | 2012-02-11 |
| Street Address |
1638 OWEN DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821091851 | Cumberland County Hospital System, Inc | General Acute Care Hospital | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2005-05-23 |
| 1265032536 | Heidi Ellen Jumbercotta | Internal Medicine | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-10-27 |
| 1346848306 | Jessica Hooten | Nurse Practitioner | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-10-13 |
| 1881200665 | Kathleen Macalalag | Pharmacist | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-09-17 |
| 1790395523 | Anna Caitlyn Felmer | Pharmacist | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-08-06 |
| 1427668359 | Benjamin Josiah Tutterow | Pharmacist | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-08-05 |
| 1063022994 | George Thomas Sessoms IIi | Pharmacist | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-08-05 |
| 1437769759 | Teresa Cooper Jones | Pharmacist | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-08-01 |
| 1881202901 | Chantel Davis | Specialist/Technologist, Other | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-07-15 |
| 1194333237 | Alyssa Worley | Occupational Therapy Assistant | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2020-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588276471 | Henrietta Elise Mckoy | Student in an Organized Health Care Education/Training Program | 913 Liberty Ln, Fayetteville, NC 28311-3073 | 2020-08-20 |
| 1346869567 | Sahiba Bajwa | Student in an Organized Health Care Education/Training Program | Uams Northwest Campus, 1125 N. College Avenue, Slot 100, Fayetteville, AR 72703-1908 | 2020-04-09 |
| 1982239463 | Ashley A Bethea | Student in an Organized Health Care Education/Training Program | 4422 Spinel Dr, Fayetteville, NC 28311-6862 | 2020-03-05 |
| 1730719329 | Jessica Claire Perrett | Student in an Organized Health Care Education/Training Program | 150 Oak Shadow Way, Fayetteville, GA 30215-2985 | 2020-01-22 |
| 1215579263 | Hallie Hawe | Student in an Organized Health Care Education/Training Program | 2084 N Chestnut Ave Apt 13, Fayetteville, AR 72703-2242 | 2019-10-10 |
| 1457992877 | Daniel Ross Barber | Student in an Organized Health Care Education/Training Program | 503 Blessings Hill Ln, Fayetteville, TN 37334-9710 | 2019-10-07 |
| 1982160982 | Timothy Glenn Higgins | Student in an Organized Health Care Education/Training Program | 1689 N Whistling Straits Ave Apt 301, Fayetteville, AR 72704-6679 | 2019-02-14 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1053821165 | Yancy T. Dials | Student in an Organized Health Care Education/Training Program | 340 Ridgemont Dr, Fayetteville, GA 30215-7708 | 2017-10-03 |
| 1881128601 | Cynthia Jackson | Student in an Organized Health Care Education/Training Program | 5100 Highbridge St Apt 47d, Fayetteville, NY 13066-2461 | 2017-04-18 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on ZACHARY CHARLES CLARK.
| 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.