DR. DAVID FREDERICK CLARK (NPI# 1629230479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629230479 |
| Entity Type | Individual |
| Full Name | DR. DAVID FREDERICK CLARK |
| Credential | MD |
| Practice Address |
12140 Nall Ave Suite 230 Overland Park KS 66209-2503 |
| Practice Telephone | 9136619448 |
| Practice Fax Number | 9136614688 |
| Mailing Telephone | 9136619448 |
| Mailing Fax Number | 9136614688 |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2013-06-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
0436405 | KS | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | OH | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225388531 | David Clark | Pharmacist | 87 Garner Rd., Cvs 4174, Spartanburg, SC 29303 | 2012-09-13 |
| 1568778793 | David F Clark | Social Worker | 4425 S Jones Blvd, Suite D3, Las Vegas, NV 89103-3370 | 2010-08-25 |
| 1407093065 | David E. Clark | Dietitian, Registered | 4132 Sierra Park Ter, Dayton, OH 45440-3324 | 2009-01-19 |
| 1962668202 | David Allen Clark | Dentist | 4209 Tieton Dr, Suite 102, Yakima, WA 98908-3377 | 2008-08-06 |
| 1548427693 | David Kyle Clark | Dentist | 2120 Bert Kouns Loop Ste D, Shreveport, LA 71118-3351 | 2008-05-16 |
| 1790957603 | David C. Clark | Pharmacist | 1215 Route 31, Macedon, NY 14502-9763 | 2008-03-31 |
| 1275722365 | David Allan Clark | Counselor | 50196 872nd Rd, Page, NE 68766-5539 | 2007-10-15 |
| 1649488214 | David D Clark | Chiropractor | 2573 N Reading Rd, Denver, PA 17517-9333 | 2007-05-18 |
| 1306059480 | David Roger Clark | Ophthalmology | 2812 Millbrook Ct, Arlington, TX 76012-2116 | 2007-05-07 |
| 1619049327 | David B Clark | Chiropractor | 106 Se 12th St, Oak Grove, MO 64075-9538 | 2006-11-15 |
| Street Address |
12140 NALL AVE SUITE 230 |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66209-2503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811988819 | Sajeev Balakrishnan Menon | Internal Medicine | 12140 Nall Ave, Suite 300, Overland Park, KS 66209 | 2005-10-31 |
| 1609312735 | Kc Core Ca LLC | Chiropractor | 12140 Nall Ave, Suite 115, Overland Park, KS 66209-2503 | 2017-01-12 |
| 1841654258 | Dr Ets Concierge Care LLC | Internal Medicine | 12140 Nall Ave, Suite 305, Overland Park, KS 66209-2503 | 2016-04-12 |
| 1356700074 | Tara S Marchello | Dietitian, Registered | 12140 Nall Ave, Suite 100, Overland Park, KS 66209 | 2016-02-23 |
| 1164891966 | Eating Disorder Treatment Associates, LLC | Clinic/Center | 12140 Nall Ave, Suite 315, Overland Park, KS 66209-2503 | 2015-09-22 |
| 1164802666 | Mccallum Place | Clinic/Center | 12140 Nall Ave, Suite 315, Overland Park, KS 66209-2503 | 2015-06-01 |
| 1285065250 | Gretchen Huebert | Dietitian, Registered | 12140 Nall Ave, Suite 100, Overland Park, KS 66209-2503 | 2013-12-02 |
| 1255768354 | Jill Soenen | Nurse Practitioner | 12140 Nall Ave, Suite 100, Overland Park, KS 66209-2503 | 2013-10-03 |
| 1013356054 | Rebecca Bennett | Dietitian, Registered | 12140 Nall Ave, Suite 100, Overland Park, KS 66209-2503 | 2013-06-24 |
| 1851737365 | Sandra T Hao | Internal Medicine | 12140 Nall Ave, Suite 300, Overland Park, KS 66209-2503 | 2013-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265900286 | Kansas Wellness Associates LLC | Family Medicine | 4300 W 133rd Street, Suite 200, Leawood, KS 66209 | 2018-11-07 |
| 1740781871 | Courtney Collins | Physical Therapy Assistant | 6830 W. 121st. Ct, Overland Park, KS 66209 | 2018-02-23 |
| 1295246015 | Meredith Meyer Bell | Nurse Practitioner | 5064 W 130th Terrace, Leawood, KS 66209 | 2017-10-19 |
| 1740712223 | Margaret Alice Luckert | Registered Nurse | 5701 W 119th Street Suite 220, Overland Park, KS 66209 | 2017-04-03 |
| 1609311133 | Kansas City Community Hospital, LLC | General Acute Care Hospital | 13200 State Line Road, Leawood, KS 66209 | 2016-12-19 |
| 1316492499 | Christy Vopat | Occupational Therapist | 4952 W. 129 Th Terr, Leawood, KS 66209 | 2016-08-18 |
| 1861846594 | Paige Aberasturi Penick | Nutritionist | 6709 W 119th St # 207, Overland Park, KS 66209 | 2016-04-19 |
| 1568827905 | Eating Disorder Treatment Associates, LLC | Clinic/Center | 12140 Nall Avenue, Suite 315, Overland Park, KS 66209 | 2015-12-30 |
| 1689056483 | Michael Hauber | Physical Therapist | 12728 State Line Rd, Leawood, KS 66209 | 2015-06-29 |
| 1033597000 | Brooke J Heppner Mft | Marriage & Family Therapist | 6711 W. 121st Street, Suite 101, Overland Park, KS 66209 | 2015-05-11 |
| Find all providers in zip 66209 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437411725 | Phaedra M. Dowell | Psychiatry & Neurology | 12140 Nall Ave Ste 230, Overland Park, KS 66209-2507 | 2012-06-12 |
| 1235413196 | Harsh Vardhan Gupta | Psychiatry & Neurology | 10777 Nall Ave Ste 200, Overland Park, KS 66211-1357 | 2011-10-10 |
| 1295770154 | Fernando M Egea | Psychiatry & Neurology | 6405 Metcalf Ave, 508, Overland Park, KS 66202-3927 | 2006-06-17 |
| 1790780310 | George R Moreng | Psychiatry & Neurology | 6409 W 125th St, Overland Park, KS 66209-2520 | 2005-06-20 |
| 1164424339 | Ian Leslie Belson | Psychiatry & Neurology | 12140 Nall, Suite 230, Overland Park, KS 66209-2503 | 2005-06-01 |
| 1962691774 | Samuel R Lehman Md Neurology | Psychiatry & Neurology | 10550 Quivira Rd Ste 520, Overland Park, KS 66215-2306 | 2007-10-17 |
| 1083730501 | Muhammad Mahdi Nashatizadeh | Psychiatry & Neurology | 10550 Quivira Rd, Suite 530, Overland Park, KS 66215-2306 | 2007-03-22 |
| 1194850115 | Johnson County Neurology LLC | Psychiatry & Neurology | 5701 W 119th St, Suite 102, Overland Park, KS 66209-3722 | 2007-02-22 |
| 1164586152 | Bernard Mark Abrams | Psychiatry & Neurology | 5520 College Boulevard, Suite 320, Overland Park, KS 66211-1690 | 2006-12-21 |
| 1801991237 | Psychiatric Practique Pa | Psychiatry & Neurology | 8645 College Blvd, Ste 220, Overland Park, KS 66210-1835 | 2006-09-13 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66209 |
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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.