KATHY CLARK (NPI# 1609120567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609120567 |
| Entity Type | Individual |
| Full Name | KATHY CLARK |
| Credential | CAT |
| Practice Address |
303 Parkway Dr Ne Atlanta GA 30312-1212 |
| Mailing Address |
3286 Steeple Dr Decatur GA 30034-5479 |
| Practice Telephone | 6785920935 |
| Practice Fax Number | 7702345103 |
| Mailing Telephone | 6785920935 |
| Mailing Fax Number | 7702355103 |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246QH0000X |
Spec/Tech, Pathology Specialization: Hematology |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 246Z00000X | Specialist/Technologist, Other | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306062435 | Kathy Ann Clark | Licensed Practical Nurse | 7772 Williamson Ln, Canal Winchester, OH 43110-8524 | 2007-04-17 |
| 1255482618 | Kathy Ann Clark | Counselor | 504 Norfolk St, Apt 2, Holliston, MA 01746-2324 | 2007-01-14 |
| 1457909087 | Kathy Clark | Technician | 2865 S Jones Blvd, Las Vegas, NV 89146-5307 | 2019-08-27 |
| 1235619511 | Kathy Ann Clark | Physical Therapist | 785 Cherry Tree Ct, Hanover, PA 17331-7902 | 2018-08-16 |
| 1487062303 | Kathy Clark | Counselor | 18 Jackson St, Suite A, Newnan, GA 30263-1910 | 2014-07-23 |
| 1720404700 | Kathy Clark | Counselor | 602 N Walton Blvd, Bentonville, AR 72712-4576 | 2014-03-13 |
| 1861762361 | Kathy M Clark | Pharmacist | 1063 N Toledo Blade Blvd, North Port, FL 34288-2400 | 2011-12-31 |
| 1811107030 | Kathy Clark | Physical Therapy Assistant | 1 Siskin Plz, Chattanooga, TN 37403-1306 | 2007-05-23 |
| 1952304701 | Kathy S Clark | Radiology | 5901 Technology Center Dr, Indianapolis, IN 46278-6013 | 2005-05-24 |
| Street Address |
303 PARKWAY DR NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30312-1212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730188368 | Rhonda Latrice Martin | Pharmacist | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2005-07-15 |
| 1275162075 | Derek Stephen Duey | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2020-04-03 |
| 1659909018 | Blake Thor Bendixen | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Atlanta, GA 30312-1239 | 2020-03-31 |
| 1902433246 | Tom John Albunian Mayuga | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2020-03-25 |
| 1114558889 | Parie Jared | Emergency Medicine | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2020-01-30 |
| 1548808827 | Sarah Deslate | Nurse Anesthetist, Certified Registered | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2019-12-17 |
| 1639714686 | Nicolai Pineda | Physician Assistant | 303 Parkway Dr Ne, Atlanta, GA 30312-1239 | 2019-11-14 |
| 1659915510 | Jason Madariaga Cuaresma | Pharmacist | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2019-11-04 |
| 1770143398 | Ga U Kim | Anesthesiologist Assistant | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2019-06-17 |
| 1396302584 | Noah Dessalegn | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2019-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770108516 | Bita Ranjbari | Physician Assistant | 659 Auburn Ave Se, Suite 505, Atlanta, GA 30312 | 2020-06-08 |
| 1609439629 | Adeyinka Edward Adeniyi | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center, 303 Parkway Drive Ne, 4th Floor, Internal Medicine Department, Atlanta, GA 30312 | 2019-04-16 |
| 1003378670 | James Spratt IIi | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Ne, 4th Floor, Wellstar Atlanta Medical Center Department of Orthopaed, Atlanta, GA 30312 | 2019-04-03 |
| 1659833440 | Derrick Edward Wendler | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center Dpt of Orthopaedics, 303 Parkway Drive Ne, 4th Floor, Atlanta, GA 30312 | 2019-04-02 |
| 1336631266 | The Atlanta Small Business Training Consortium, Inc. | Local Education Agency (LEA) | 250 Georgia Ave Se Ste 207a, Atlanta, GA 30312 | 2018-06-06 |
| 1669960134 | Derek Mccranie | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Atlanta, FL 30312 | 2018-04-30 |
| 1336646223 | Amy Ruth Williams | Nurse Practitioner | 383 Ralph Mcgill Blvd Ne Apt D, Atlanta, GA 30312 | 2018-04-09 |
| 1730689183 | Lisa Marie Margavage | Chiropractor | 720 Ralph Mcgill Blvd Ne Unit 210, Atlanta, GA 30312 | 2018-02-12 |
| 1922518836 | Rodney Aldridge | Registered Nurse | 250 Georgia Avenue, Suite 206, Atlanta, GA 30312 | 2017-10-05 |
| 1629599279 | Huda Hashim Elsamani Elsheikh | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Wellstar Atlanta Medical Center, Dept of Graduate Medical Education, Internal Medicine, Atlanta, GA 30312 | 2017-07-05 |
| Find all providers in zip 30312 | ||||
| Taxonomy Code | 246QH0000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Pathology |
| Specialization | Hematology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447767504 | Kristin K Deeb | Spec/Tech, Pathology | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2018-01-10 |
| 1669677241 | Debra Fay Saxe | Spec/Tech, Pathology | Emory University Hospital, Suite F143, Atlanta, GA 30322-0001 | 2007-06-15 |
Please comment or provide details below to improve the information on KATHY 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.