DR. JESSICA LYNN CLARK (NPI# 1740449719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740449719 |
| Entity Type | Individual |
| Full Name | DR. JESSICA LYNN CLARK |
| Credential | MD |
| Practice Address |
12139 Panama City Beach Pkwy Panama City Beach FL 32407-2609 |
| Mailing Address |
12469 Emerald Coast Pkwy W Miramar Beach FL 32550-8305 |
| Practice Telephone | 8506543376 |
| Practice Fax Number | 8506543320 |
| Mailing Telephone | 8506543376 |
| Mailing Fax Number | 8506543320 |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2016-05-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | ME127249 | FL | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | N3566 | TX | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528690906 | Jessica Clark | Doula | 343 N Main Ave, Gresham, OR 97030-7246 | 2020-02-04 |
| 1962054387 | Jessica Lynn Clark | Nurse Practitioner | 7219 N Litchfield Rd Bldg 11302nd, Luke Air Force Base, AZ 85309-1529 | 2019-07-16 |
| 1568962306 | Jessica Lee Clark | Registered Nurse | 6011 Cielo Rnch, San Antonio, TX 78218-4161 | 2018-02-19 |
| 1811416076 | Jessica Clark | Counselor | 42189 Shadow Creek Ave, Gonzales, LA 70737-7241 | 2017-09-19 |
| 1124572821 | Jessica Clark | Specialist | 5664 Cahuenga Blvd, North Hollywood, CA 91601-2103 | 2016-08-10 |
| 1104286871 | Jessica Clark | Counselor | 2575 Westgate Bldg 2, Pendleton, OR 97801-9613 | 2016-02-24 |
| 1942612296 | Jessica Clark | Case Management | 620 John Austin Ln, Mt Washington, KY 40047-6354 | 2014-05-21 |
| 1154610269 | Jessica Clark | Social Worker | 55 Floyd Ave, Riverside, RI 02915-2927 | 2011-03-30 |
| 1346558780 | Jessica Clark | Dietitian, Registered | 187-191 Main Street, Ste 300, Emmaus, PA 18049-4017 | 2010-09-20 |
| 1760794309 | Jessica Michelle Clark | Dentist | 1300 Kempsville Rd Ste 5, Virginia Beach, VA 23464-6199 | 2010-07-12 |
| Street Address |
12139 PANAMA CITY BEACH PKWY |
| City | PANAMA CITY BEACH |
| State | FL |
| Zip Code | 32407-2609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487011722 | Doug Guilbault | Chiropractor | 12139 Panama City Beach Pkwy, Panama City Beach, FL 32407-2609 | 2016-01-18 |
| 1518322700 | Kyle Gavin Rountree | Nurse Practitioner | 12139 Panama City Beach Pkwy, Panama City Beach, FL 32407-2609 | 2015-12-15 |
| 1770985509 | Samuel David Kranz | Chiropractor | 12139 Panama City Beach Pkwy, Panama City Beach, FL 32407-2609 | 2014-09-24 |
| 1295165983 | Mikala Weatherhead | Chiropractor | 12139 Panama City Beach Pkwy, Panama City Beach, FL 32407-2609 | 2013-11-18 |
| 1083984736 | Brian Scott Farrell | Chiropractor | 12139 Panama City Beach Pkwy, Panama City Beach, FL 32407-2609 | 2012-01-11 |
| 1639447253 | Christopher Ohsie | Chiropractor | 12139 Panama City Beach Pkwy, Panama City Beach, FL 32407-2609 | 2011-12-09 |
| 1235434945 | Paige M Hanger | Chiropractor | 12139 Panama City Beach Pkwy, Panama City Beach, FL 32407-2609 | 2011-01-12 |
| 1922003789 | Sylvia M Smith | Chiropractor | 12139 Panama City Beach Pkwy, Panama City Beach, FL 32407-2609 | 2005-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235637497 | Beach Midway Med Express | Internal Medicine | 11038 Hutchison Blvd, Panama City, FL 32407 | 2018-01-23 |
| 1225497365 | Shae Nicole Luster | Counselor | 415 N Richard Jackson Blvd Ste 204, Panama City Beach, FL 32407 | 2016-02-17 |
| 1447675988 | Nicoleta M Tatum | Nurse Practitioner | 140 N Richard Jackson Blvd, Panama City Beach, FL 32407 | 2014-02-20 |
| 1528482361 | Best Care Home Health of Panama City LLC | Home Health | 12216 Panama City Parkway Unit B, Panama City Beach, FL 32407 | 2014-02-14 |
| 1134463482 | Panhandle Orthopaedics LLC | Pediatrics | 12909 Panama City Beach Pkwy, Panama City Beach, FL 32407 | 2012-11-26 |
| 1215296983 | Jennifer Lynn Holloran | Speech-Language Pathologist | 8317 Front Beach Road Suite 34c, Panama City Beach, FL 32407 | 2012-05-15 |
| 1295043248 | Candida Jill Pratt | Massage Therapist | 10200 Clarence St., Suite B, Panama City Beach, FL 32407 | 2010-09-23 |
| 1326275843 | Richard Lee Giffin | Registered Nurse | 1625 Vecuna Cir, Panama City Beach, FL 32407 | 2009-06-11 |
| 1649455726 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 11801 Panama City Beach Pkwy., Panama City Beach, FL 32407 | 2008-01-08 |
| 1891915740 | Cambridge Carruth | Physical Therapist | 120 R Jackson Bvld., Ste. 130, Panama City Beach, FL 32407 | 2007-04-25 |
| Find all providers in zip 32407 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922346956 | Gulf Coast Dermatology & Skin Care Centre Pllc | Dermatology | 10800 Panama City Beach Pkwy, Suite 200, Panama City Beach, FL 32407-2533 | 2013-01-25 |
| 1053610550 | Dermatology Associates of Bay County, P.a. | Dermatology | 12234 Panama City Beach Pkwy, Suite D, Panama City Beach, FL 32407-2725 | 2011-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002154 | Precision Skin LLC | Dermatology | 3501 S University Dr Ste 5, Davie, FL 33328-2001 | 2020-10-28 |
| 1487252417 | Janice Reaume | Dermatology | 3335 Imperial Manor Way, Mulberry, FL 33860-5519 | 2020-10-12 |
| 1922617729 | Synergymd, LLC | Dermatology | 1208 E Kennedy Blvd Ste 221, Tampa, FL 33602-3509 | 2020-07-28 |
| 1518585447 | Alexander F Wong | Dermatology | 1300 Goodlette-frank Rd N, Naples, FL 34102-5243 | 2020-07-07 |
| 1508495003 | Elite Dermatology | Dermatology | 401 Coral Way Ste 207, Coral Gables, FL 33134-4924 | 2020-04-06 |
| 1124668371 | Meaghan Margaret Birakis | Dermatology | 3319 Fl-7 #202, Wellington, FL 33449 | 2020-01-15 |
| 1396380044 | Suzanne Marie Smith | Dermatology | 21097 Ne 27th Ct Ste 500, Miami, FL 33180-1235 | 2019-11-15 |
| 1376188383 | Enchantress Dermatology, Inc. | Dermatology | 241 Nw 119 Ave, Miami, FL 33182-1329 | 2019-11-13 |
| 1699319988 | Revivify Dermatology, LLC | Dermatology | 21301 Powerline Rd # 108, Boca Raton, FL 33433-2388 | 2019-10-30 |
| 1841833928 | Carly Marie Maher | Dermatology | 90 Cypress Way E Ste 50, Naples, FL 34110-9275 | 2019-10-22 |
| Find all providers with the same taxonomy | ||||
| City | PANAMA CITY BEACH |
| Zip Code | 32407 |
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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.