SUSAN CLARK (NPI# 1619215225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619215225 |
| Entity Type | Individual |
| Full Name | SUSAN CLARK |
| Credential | RN, CDE |
| Practice Address |
5601 Loch Raven Blvd Good Health Center, O'neil Bldg 2nd Fl Baltimore MD 21239-2945 |
| Practice Telephone | 4434444550 |
| Mailing Telephone | 4434444550 |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
RN144178 | MD | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161950 | Susan Marie Clark | Nurse Practitioner | 674 Coral Way, Winter Springs, FL 32708-3127 | 2020-07-09 |
| 1528591575 | Susan Clark | Counselor | 604 S Walnut, Stillwater, OK 74074-4222 | 2017-04-06 |
| 1790178556 | Susan March Clark | Peer Specialist | 3277 E 2nd St, Tulsa, OK 74104-2134 | 2015-03-17 |
| 1841537990 | Susan Noble Clark | Developmental Therapist | 1730 Radcliffe Rd, Montgomery, AL 36106-2620 | 2013-01-09 |
| 1881963411 | Susan Clark | Occupational Therapy Assistant | 38 Wheeler Ave, Warwick, NY 10990-1341 | 2011-12-28 |
| 1437302684 | Susan Maslin Clark | Chiropractor | 20416 Bowfonds St, Ashburn, VA 20147-7457 | 2008-11-01 |
| 1871780940 | Susan Marie Clark | Counselor | 112 S Water St Ste B, Kent, OH 44240-3689 | 2007-10-02 |
| 1750403861 | Susan M Clark | Psychologist | 1022 Cherokee Ave, Royal Oak, MI 48067 | 2007-04-06 |
| 1598892085 | Susan L Clark | Psychiatry & Neurology | 9515 60th Ave W, Mukilteo, WA 98275 | 2007-02-28 |
| 1609968692 | Susan M Clark | Pediatrics | 1318 S Main Road, Vineland, NJ 08360 | 2006-09-28 |
| Street Address |
5601 LOCH RAVEN BLVD GOOD HEALTH CENTER, O'NEIL BLDG 2ND FL |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21239-2945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316940588 | Paul Byron Fowler | Specialist | 5601 Loch Raven Blvd, Baltimore, MD 21239-2905 | 2005-05-23 |
| 1992328017 | Kaitlin Lee | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-05-22 |
| 1023646692 | Akiko Rockers | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-03-30 |
| 1578199519 | Erica Wilson | Pharmacist | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-03-22 |
| 1154952497 | Kimberly Jo Jenko | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-01-27 |
| 1679103576 | Nerland Dimanche | Registered Nurse | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-01-20 |
| 1063058782 | Simcha Gratz | Nurse Practitioner | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-11-19 |
| 1548817737 | Christopher Burgess | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-08-22 |
| 1114571809 | Lauren Delmonico | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-07-30 |
| 1750943411 | Sana Tanveer Ahmed | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255809273 | Books of Color, LLC | Student in an Organized Health Care Education/Training Program | 1222 Walker Ave, Baltimore, MD 21239 | 2018-11-07 |
| 1902381353 | Brandon Wilson | Physician Assistant | 5601 Lochraven Blvd, Baltimore, MD 21239 | 2018-10-02 |
| 1629563879 | Ashley C Sayles | Nurse Practitioner | 5601 Loch Raven Blvd Ste 200, Baltimore, MD 21239 | 2018-06-28 |
| 1164940656 | Tarnisha Fitzgerald | Nurse Practitioner | 1601 East Belvedere Avenue, Baltimore, MD 21239 | 2017-09-05 |
| 1083153803 | J.pope & Associates, LLC | Counselor | 1800 E. Northern Pkwy #28031, Baltimore, MD 21239 | 2017-02-13 |
| 1417336017 | Mana Ali | Psychologist | 5601 Loch Raven Blvd Ste 406, Johns Hopkins Som Dept of Physical Med and Rehab, Baltimore, MD 21239 | 2015-05-28 |
| 1730597766 | Ramona Taylor-knox | Counselor | 1700 Meridian Drive, Suite 611, Baltimore, MD 21239 | 2014-07-22 |
| 1013259142 | Innovative Healing Solutions,llc | Social Worker | 1302 Silverthorne Rd, Baltimore, MD 21239 | 2013-03-27 |
| 1962744268 | Mohamad Hanouneh | Internal Medicine | 5601 Loch Raven Blvd Ste 3n, Baltimore, MD 21239 | 2013-03-25 |
| 1164713350 | Vanessa G Brown | Pharmacist | 5618 The Alameda, Baltimore, MD 21239 | 2011-04-22 |
| Find all providers in zip 21239 | ||||
| Taxonomy Code | 163WD0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Diabetes Educator |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487957841 | Susan Aldape | Registered Nurse | 7141 Security Blvd, Baltimore, MD 21244-1811 | 2010-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689079097 | Deborah Azuine | Registered Nurse | 11503 Burning Tree Ct, Bowie, MD 20721-2360 | 2014-10-28 |
| 1720324940 | Helen Anne Jenkins | Registered Nurse | 7516 Topton St, New Carrollton, MD 20784-3539 | 2012-12-15 |
| 1326372921 | Adeola Olawole Akindana | Registered Nurse | 8118 Good Luck Rd Ste 500, Lanham, MD 20706 | 2009-09-29 |
| 1558863894 | Wendy Cossman | Registered Nurse | 11603 Glynshire Ct, Potomac, MD 20854-2029 | 2018-03-02 |
| 1134627862 | Michelle Wiltison | Registered Nurse | 251 N 4th St, Oakland, MD 21550-1375 | 2018-01-29 |
| 1912327412 | Linda Mino | Registered Nurse | 5500 Buckeystown Pike, Fmh Wellness, Frederick, MD 21701-2870 | 2014-04-23 |
| 1366862260 | Susan Baldwin | Registered Nurse | 5500 Buckeystown Pike, Fmh Wellness Center, Frederick, MD 21703-8331 | 2014-04-18 |
| 1366862419 | Janice Drass | Registered Nurse | 5500 Buckeystown Pike, Frederick, MD 21703-8331 | 2014-04-16 |
| 1396174371 | Virginia Lee Mccarty | Registered Nurse | 15005 Shady Grove Rd, Suite 120, Rockville, MD 20850-6340 | 2013-11-11 |
| 1457786493 | Jennifer Appleby | Registered Nurse | 5500 Knoll North Dr, Suite 200, Columbia, MD 21045-2370 | 2013-09-10 |
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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.