KRISTIE DAWN CLARK (NPI# 1619222932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619222932 |
| Entity Type | Individual |
| Full Name | KRISTIE DAWN CLARK |
| Credential | PHARMD, CDE |
| Practice Address |
200 Medical Park Dr Ste 550 Concord NC 28025-2982 |
| Practice Telephone | 7044031307 |
| Practice Fax Number | 7044033655 |
| Mailing Telephone | 7044031307 |
| Mailing Fax Number | 7044033655 |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2012-07-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
17299 | NC | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548744568 | Kristie E Clark | Pharmacist | 3775 E Tremont Ave, Bronx, NY 10465-2432 | 2018-09-17 |
| 1376928366 | Kristie Ann Clark | Counselor | 5090 State St, Suite 102-b, Saginaw, MI 48603-7706 | 2015-07-20 |
| 1558473884 | Kristie M Clark | Pediatrics | 810 W Bramley St, Jetmore, KS 67854-9320 | 2006-08-31 |
| Street Address |
200 MEDICAL PARK DR STE 550 |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-2982 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346245040 | Myron Roddenberry | Physician Assistant | 200 Medical Park Dr, Suite 230, Concord, NC 28025-2982 | 2005-06-17 |
| 1679183776 | Carolinas Physicians Network Inc | Orthopaedic Surgery | 200 Medical Park Dr, Ste 500, Concord, NC 28025-2982 | 2020-08-04 |
| 1518577832 | Leah Mccain | Nurse Practitioner | 200 Medical Park Dr, Ste 230, Concord, NC 28025-2982 | 2020-08-01 |
| 1477198091 | Ryan Cannici | Nurse Practitioner | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2019-11-07 |
| 1881159341 | Jessica Surane | Physician Assistant | 200 Medical Park Dr, Ste 230, Concord, NC 28025-2982 | 2019-02-08 |
| 1740756253 | Samantha Mason | Nurse Practitioner | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2018-10-23 |
| 1700361466 | Montana Poe | Nurse Practitioner | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2018-09-28 |
| 1932695574 | Stephanie White | Nurse Practitioner | 200 Medical Park Dr, Ste 430, Concord, NC 28025-2982 | 2018-07-06 |
| 1487185534 | Mukunda Singh | Internal Medicine | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2017-03-21 |
| 1497207641 | Jessica Marchal | Physician Assistant | 200 Medical Park Dr, Ste 230, Concord, NC 28025-2982 | 2016-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
| 1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
| 1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
| 1437677085 | Kathryn Emily Kanauer | Counselor | 280 Executive Park Dr Ne, Concord, NC 28025 | 2017-09-05 |
| 1649794439 | Foster Health & Homecare, LLC | Home Health | 363 Church Street North, Suite 260-i, Concord, NC 28025 | 2017-08-02 |
| 1326569336 | Jessie Leigh Tilley-compton | Social Worker | 371 Amhurst St Sw, Concord, NC 28025 | 2017-06-29 |
| 1609305663 | Sarah Katherine Thompson | Licensed Practical Nurse | 248 Executive Park Dr, Concord, NC 28025 | 2017-06-05 |
| 1023463098 | Kiera Brown | Social Worker | 219 Lephillip Court, Concord, NC 28025 | 2016-04-27 |
| 1992169445 | Brittiny N. Ingram Vanterpool | Counselor | 250 Branchview Dr Sw, Concord, NC 28025 | 2016-04-11 |
| 1215399852 | The Charlotte-mecklenburg Hospital Authority | Clinic/Center | 840 Warren C. Coleman Blvd, Concord, NC 28025 | 2016-03-23 |
| Find all providers in zip 28025 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629537675 | Anna Kerimov Bahr | Pharmacist | 125 N Main St Ste 1, Concord, NH 03301-4985 | 2019-03-19 |
| 1558843896 | Laura Elizabeth Martin | Pharmacist | 133 Old Rd 9 Acre Cor, Concord, MA 01742-4169 | 2018-09-04 |
| 1609428572 | Alyssa Lee | Pharmacist | 315 Medical Park Dr, Concord, NC 28025-1902 | 2019-07-11 |
| 1093216244 | Chris Larck | Pharmacist | 100 Medical Park Dr, Concord, NC 28025-2948 | 2018-02-23 |
| 1639609530 | Drew Thompson | Pharmacist | 5408 Ygnacio Valley Rd, Concord, CA 94521 | 2017-06-14 |
| 1730624966 | Tong-i King | Pharmacist | 133 Old Road To 9 Acre Cor, Concord, MA 01742-4159 | 2016-12-26 |
| 1124465976 | Erin Roach | Pharmacist | 200 Medical Park Dr Ste 280, Concord, NC 28025-0935 | 2013-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912506270 | Tyler Stone | Pharmacist | Medical Center Blvd 7th Floor Janeway Tower, Winston Salem, NC 27157-0001 | 2020-10-19 |
| 1366913030 | Chi Hornik | Pharmacist | Duke Children's Hospital Erwin Road, Durham, NC 27710-0001 | 2018-12-06 |
| 1255808234 | Cathy Wilson Fuquay | Pharmacist | 8519 Haw River Rd, Oak Ridge, NC 27310-9832 | 2018-10-29 |
| 1780162990 | Carol Lowe Holmes | Pharmacist | 2479 South Church Street, Address Line 2, Burlington, NC 27215-2721 | 2018-07-31 |
| 1528553575 | David Amtower | Pharmacist | 1100 Tunnel Rd Dept 119, Asheville, NC 28787-2576 | 2018-06-22 |
| 1235645961 | Donna Lynn Topping | Pharmacist | 20 Duke Medicine Cir # 2-2, Durham, NC 27710-2000 | 2017-12-18 |
| 1386156099 | Jungeun Ahn | Pharmacist | 507 Palafox Dr, Chapel Hill, NC 27516-1175 | 2017-11-03 |
| 1669929766 | Deborah Currie | Pharmacist | 6202 Marigold Ct, Waxhaw, NC 28173-8289 | 2016-09-06 |
| 1467905026 | Amarachi Enyinnaya | Pharmacist | 301 Crescendo Dr, Morrisville, NC 27560-5724 | 2016-08-01 |
| 1831557172 | Joe Brewton | Pharmacist | 4841 Linksland Dr, Holly Springs, NC 27540-8352 | 2016-02-01 |
| 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.