DR. GREG D CLARK (NPI# 1629046289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629046289 |
| Entity Type | Individual |
| Full Name | DR. GREG D CLARK |
| Credential | D.P.M |
| Practice Address |
2130 Highway 35 Bldg C Ste 312 Sea Girt NJ 08750-1010 |
| Practice Telephone | 7329748200 |
| Practice Fax Number | 7329740190 |
| Mailing Telephone | 7329748200 |
| Mailing Fax Number | 7329740190 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2010-03-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 25MD00282000 | NJ | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | DEA | BC9275199 | 01 |
| NJ | CDS | D08685300 | 01 |
| NJ | LICENSE | 25MD00282000 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629358395 | Greg Clark | Physical Therapy Assistant | 2105 Bristol Dr, Jonesboro, AR 72401-8505 | 2011-08-25 |
| Street Address |
2130 HIGHWAY 35 BLDG C STE 312 |
| City | SEA GIRT |
| State | NJ |
| Zip Code | 08750-1010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316932213 | Sung Woo Paik | Physical Medicine & Rehabilitation | 2130 Highway 35, Ste B-216, Sea Girt, NJ 08750-1010 | 2005-09-16 |
| 1023543485 | Holly C Gaul | Counselor | 2130 Highway 35, Suite A-114, Sea Girt, NJ 08750-1010 | 2017-04-24 |
| 1689117673 | Shore Perinatal Associates | Obstetrics & Gynecology | 2130 Highway 35, Suite 123a, Sea Girt, NJ 08750-1010 | 2016-11-23 |
| 1013391291 | Jennifer Sanfilippo | Nurse Practitioner | 2130 Highway 35, 321 C, Sea Girt, NJ 08750-1010 | 2015-07-16 |
| 1174935597 | Studio 2020 Vision Care | Optometrist | 2130 Highway 35, Sea Girt, NJ 08750-1010 | 2014-05-21 |
| 1669892709 | Shore Endodontics of Sea Girt Pa | Dentist | 2130 Highway 35, Sea Girt, NJ 08750-1010 | 2014-04-16 |
| 1992135883 | Elegant Smiles of Sea Girt LLC | Dentist | 2130 Highway 35, Suite 211, Sea Girt, NJ 08750-1010 | 2013-11-14 |
| 1235476979 | Cornerstone Speech and Language | Speech-Language Pathologist | 2130 Highway 35, Suite 311, Sea Girt, NJ 08750 | 2013-01-15 |
| 1841592144 | Partners In Freedom LLC | Non-Pharmacy Dispensing Site | 2130 Highway 35, Suite 324 - 2nd Floor, Sea Girt, NJ 08750-1010 | 2010-11-19 |
| 1346562717 | Jasvinder Kaur Pabla | Optometrist | 2130 Highway 35, Suite 111, Sea Girt, NJ 08750-1010 | 2010-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861056020 | Aileen Almonte | Dentist | 804 Nj-71, Sea Girt, NJ 08750 | 2019-04-23 |
| 1205302510 | Ilona Poley | Physician Assistant | 2130 Nj-35, Ste 321c, Sea Girt, NJ 08750 | 2018-10-15 |
| 1619458551 | Joan Marie Akins | Speech-Language Pathologist | Cornerstone Speech & Language LLC, 2130 Highway 35 Suite 311, Sea Girt, NJ 08750 | 2018-08-28 |
| 1437650207 | Maryna Hall | Nurse Practitioner | 700 Highway 71 Ste 9, Sea Girt, NJ 08750 | 2018-02-26 |
| 1144674763 | Seraya Ghoneim | Hearing Instrument Specialist | 700 Brooklyn Boulevard, Sea Girt, NJ 08750 | 2016-04-20 |
| 1902246044 | Encore Dental of Wall | Dentist | 1500 Meeting House Rd., Sea Girt, NJ 08750 | 2013-07-03 |
| 1891904967 | Lisa Jenny Hou | Otolaryngology | Bldg 64 Academy Way, Medical Command - National Guard Training Center, Sea Girt, NJ 08750 | 2007-05-22 |
| 1427276450 | Shore Geriatrics, LLC | Internal Medicine | 700 Route 71, Sea Girt, NJ 08750 | 2007-04-23 |
| 1164541124 | Kesha Renee Walton | Registered Nurse | 2130 Hwy 35 Suite 324, Sea Girt, NJ 08750 | 2007-03-28 |
| 1063556199 | Anthony Scott Garrow | Chiropractor | 2204 Hwy. 35, Sea Girt, NJ 08750 | 2007-02-20 |
| Find all providers in zip 08750 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881666550 | Adult Pediatric Foot and Ankle | Podiatrist | Laurel Ave Hwy 35, Sea Girt, NJ 08750 | 2006-02-06 |
| 1508834151 | James Patrick Sullivan | Podiatrist | 2130 Highway 35, Bldg C Ste 312, Sea Girt, NJ 08750-1010 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689102 | Foot and Soul | Podiatrist | 1 W State St, Trenton, NJ 08608-1205 | 2020-11-03 |
| 1407461387 | Quality Foot and Ankle Center | Podiatrist | 87 Bruswick Wood Dr, East Brunswick, NJ 08816-5601 | 2020-09-09 |
| 1992323844 | Ventnor Wellness | Podiatrist | 6601 Ventnor Ave # Troy12, Ventnor City, NJ 08406-2167 | 2020-07-08 |
| 1891310967 | Kathryn Stoedter Dpm LLC | Podiatrist | 69 Haddonfield Berlin Rd, Cherry Hill, NJ 08034-3572 | 2020-06-14 |
| 1316560576 | Quality Foot Care Center LLC | Podiatrist | 25 Clyde Rd Ste 101, Somerset, NJ 08873-5038 | 2020-05-22 |
| 1942834973 | Foot & Ankle Center of Sj | Podiatrist | 408 Chris Gaupp Dr Ste 300, Galloway, NJ 08205 | 2020-02-28 |
| 1902437643 | Harsh Patel Dpm Pa | Podiatrist | 4991 Route 42 Ste 8a, Turnersville, NJ 08012-1750 | 2020-01-31 |
| 1619508355 | Harsh Patel Dpm Pa | Podiatrist | 1529 Route 206 Ste L-1, Tabernacle, NJ 08088-8801 | 2020-01-31 |
| 1154980944 | New Jersey Podiatric Physicians & Surgeons Group LLC | Podiatrist | 2477 Hwy 516 Ste 101, Old Bridge, NJ 08857-4603 | 2019-06-06 |
| 1972068575 | Kathryn Stoedter, Dpm, LLC | Podiatrist | 2301 E Evesham Rd Ste 508, Voorhees, NJ 08043-4506 | 2019-02-07 |
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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.