DR. SIMON CLARK (NPI# 1629335534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629335534 |
| Entity Type | Individual |
| Full Name | DR. SIMON CLARK |
| Credential | D.O. |
| Practice Address |
6810 Jefferson Hwy Apt 2107 Baton Rouge LA 70806-8175 |
| Mailing Address |
6810 Jefferson Hwy Apartment # 2107 Baton Rouge LA 70806-8175 |
| Practice Telephone | 8167693200 |
| Mailing Telephone | 8167693200 |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2015-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | D.O. 0000343 | LA | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 2015016613 | MO | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
6810 JEFFERSON HWY APT 2107 |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70806-8175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831558600 | Shereva Lewis | Counselor | 6810 Jefferson Hwy, Apt # 10103, Baton Rouge, LA 70806-8175 | 2016-02-22 |
| 1184027195 | Louisiana State Psychiatry LLC | Psychiatry & Neurology | 6810 Jefferson Hwy, Apt 1309, Baton Rouge, LA 70806-8175 | 2014-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467064790 | Horizon Network LLC | Community/Behavioral Health | 921 Lobdell Blvd Suite D, Baton Rouge, LA 70806 | 2020-08-18 |
| 1093324220 | Raghu Rudraraju | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard Baton Rouge General Mid City Medi, Suite 130, Baton Rouge, LA 70806 | 2020-07-23 |
| 1619595584 | Brown's Pharmacy, LLC | Pharmacy | 1718 North Foster Drive, Suite B, Baton Rouge, LA 70806 | 2020-07-08 |
| 1497374847 | Yara Mouawad | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Suite 130, Baton Rouge, LA 70806 | 2020-04-15 |
| 1396364527 | Sai Samyuktha Bandaru | Student in an Organized Health Care Education/Training Program | Brg Mid City Medicine Clinic, 3401 North Boulevard, Sui, Baton Rouge, LA 70806 | 2020-04-08 |
| 1588299812 | Iraneeka S Gustave | Peer Specialist | Kelwood Ave, 8326 Kelwood Ave, Baton Rouge, LA 70806 | 2020-03-06 |
| 1518522192 | Silpita Katragadda | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Brg Midcity Medicine Clinic, Suite 130, Baton Rouge, LA 70806 | 2019-05-08 |
| 1437713997 | Dental Solutions, LLC | Dentist | 5629 Government St, Baton Rouge, LA 70806 | 2019-04-30 |
| 1699249516 | Shea Lafountain | Counselor | 624 Connell's Park Lane, Baton Rouge, LA 70806 | 2019-01-14 |
| 1033682802 | Genesis Specialty Groups, LLC | Clinic/Center | 778 Chevelle Drive, Baton Rouge, LA 70806 | 2019-01-04 |
| Find all providers in zip 70806 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639533755 | Elizabeth Hays Boyle Cassels | Emergency Medicine | 4256 Brittany Drive, Baton Rouge, LA 70808 | 2016-04-06 |
| 1215356340 | Kyle Patrick Pfefferle | Emergency Medicine | 3113 Grand Way Ave, Baton Rouge, LA 70810-0422 | 2014-04-16 |
| 1396163713 | Louis Gordon Pruitt | Emergency Medicine | 2122 Perkins Palm Ave Apt 309, Baton Rouge, LA 70808-7602 | 2014-04-02 |
| 1942627203 | Tara Doran | Emergency Medicine | 9099 Lake Mist Dr, Baton Rouge, LA 70810 | 2014-03-25 |
| 1366880015 | Daron Dale Davis | Emergency Medicine | 5246 Brittany Drive, Lsu Health Emergency Medicine Residency Program, Baton Rouge, LA 70808 | 2013-06-04 |
| 1558704098 | Landon Mark Hatfield | Emergency Medicine | 8929 Worthington Estates Avenue, Baton Rouge, LA 70810 | 2013-04-15 |
| 1326481268 | John Christopher Michael | Emergency Medicine | 5246 Brittany Dr Fl 3, Baton Rouge, LA 70808-9136 | 2013-04-10 |
| 1619310828 | Charles John Haase IIi | Emergency Medicine | 8733 Siegen Ln # 101, Baton Rouge, LA 70810-1945 | 2013-04-08 |
| 1972861292 | Karen George | Emergency Medicine | 13465 Parwood Ave, Baton Rouge, LA 70816-1470 | 2012-04-24 |
| 1932491248 | Jay Francis Leblanc Jr. | Emergency Medicine | 10235 Glen Manor Ave, Baton Rouge, LA 70809-3877 | 2011-05-04 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70806 |
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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.