MS. CRYSTAL A CLARK (NPI# 1639443658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639443658 |
| Entity Type | Individual |
| Full Name | MS. CRYSTAL A CLARK |
| Credential | CMA |
| Practice Address |
331 Jamestown Ct Columbus OH 43228-4030 |
| Mailing Address |
Po Box 2892 Columbus OH 43216-2892 |
| Practice Telephone | 6014803968 |
| Mailing Telephone | 6014803968 |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 372500000X | Chore Provider | Nursing Service Related Providers | ||
| N | 372600000X | Adult Companion | Nursing Service Related Providers | ||
| N | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers | ||
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers | ||
| N | 376J00000X | Homemaker | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619581311 | Crystal Clark | Massage Therapist | 12506 Ne 4th Ave Apt 101, North Miami, FL 33161-4668 | 2020-09-01 |
| 1366068470 | Crystal Sherase Clark | Technician | 4429 Grant St Ne, Washington, DC 20019-4739 | 2020-06-24 |
| 1467014894 | Crystal Clark | Chore Provider | 153 Brambury Dr Apt D, Rochester, NY 14621-1820 | 2019-07-06 |
| 1386112050 | Crystal Lynn Clark | Internal Medicine | 12056 224th St, Cambria Heights, NY 11411-2141 | 2018-11-11 |
| 1154898179 | Crystal B Clark | Family Medicine | 112 Woodland Drive, Lancaster, SC 29720 | 2018-10-29 |
| 1801259619 | Crystal Clark | Technician, Other | 3400 State St # 750, Salem, OR 97301-5861 | 2016-03-30 |
| 1467829911 | Crystal Lynn Clark | Specialist/Technologist | 1500 Manley St, Dalton High School, Dalton, GA 30720-4088 | 2015-08-31 |
| 1386073070 | Crystal Shawn Clark | Nurse Anesthetist, Certified Registered | 240 W Sugar Loaf Rd, Tucson, AZ 85737-3756 | 2013-11-04 |
| 1417391160 | Crystal Joan Clark | Nurse Practitioner | 11930 Arbor St Ste 200, Omaha, NE 68144-2998 | 2013-04-24 |
| 1952677700 | Crystal Nache Clark | Counselor | 13902 Sage Thrasher Lane, Riverview, FL 33579 | 2012-03-27 |
| Street Address |
331 JAMESTOWN CT |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43228-4030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629694229 | The Laurels of West Columbus, LLC | Skilled Nursing Facility | 441 Norton Rd, Columbus, OH 43228 | 2020-06-19 |
| 1538788146 | Colin Rogers | Student in an Organized Health Care Education/Training Program | Ohiohealth Doctors Hospital, 5100 West Broad Street, Columbus, OH 43228 | 2020-04-14 |
| 1093343899 | Cameron Alvin Gachett | Student in an Organized Health Care Education/Training Program | Ohiohealth Doctors Hospital Community Medicine Clinic, 50 Old Village Road, Columbus, OH 43228 | 2020-03-29 |
| 1407483431 | Zachary Werner | Student in an Organized Health Care Education/Training Program | Ohio Health Doctors Hospital, 5100 West Broad Street, Columbus, OH 43228 | 2020-03-27 |
| 1831684232 | Medcare Clinic LLC | Clinic/Center | 4125 W Broad St, Columbus, OH 43228 | 2018-06-27 |
| 1952893950 | Midland Medical Group, LLC | Family Medicine | 1000 Georgesville Rd, Columbus, OH 43228 | 2018-06-05 |
| 1619478336 | Charles Norris Fennie | Student in an Organized Health Care Education/Training Program | Doctors Hospital Community Medicine Clinic, 50 Old Village Road, Columbus, OH 43228 | 2018-02-27 |
| 1902304389 | Icare Health & Wellness Medical Center, LLC | Counselor | 5152 W.broad St, Suite A, Columbus, OH 43228 | 2018-01-31 |
| 1104334523 | Inner Health Chiropractic, Inc | Chiropractor | 5125 West Broad Street, Inner Health Chiropractic, Columbus, OH 43228 | 2018-01-19 |
| 1205363777 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2182 Dividend Drive, Columbus, OH 43228 | 2017-05-16 |
| Find all providers in zip 43228 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385656 | D'andra L Woods | Technician | 2210 Eden Ave, Columbus, OH 43224-1568 | 2020-10-29 |
| 1538769484 | Lisa Marie Keister | Technician | 4593 Rodney Rd, Columbus, OH 43227-1339 | 2020-10-29 |
| 1437759925 | Maria Exsentico | Technician | 3372 Norwalk Rd, Columbus, OH 43207-3331 | 2020-10-26 |
| 1396344982 | Ashley Carpenter | Technician | 1815 Case Rd, Columbus, OH 43224-2203 | 2020-10-23 |
| 1598363186 | Jared Buckingham | Technician | 1979 N 4th St, Columbus, OH 43201-1728 | 2020-10-15 |
| 1114525193 | Bivens Nursing Services | Technician | 1123 Brown Ave, Columbus, GA 31906-2404 | 2020-10-13 |
| 1144835711 | Balinda Kay Walters | Technician | 556 S Murray Hill Rd, Columbus, OH 43228-1952 | 2020-09-10 |
| 1215593587 | Raymond Jay Ellis | Technician | 2455 Sullivant Ave, Columbus, OH 43204 | 2019-05-13 |
| 1891359964 | Alisha D Saffold | Technician | 1374 Chesterton Sq S, Columbus, OH 43229-2649 | 2019-04-24 |
| 1942716956 | Matthew D Jones | Technician | 61 Sunnyside Ln, Columbus, OH 43214-1219 | 2017-12-28 |
| Find all providers in COLUMBUS | ||||
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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.