KATHRYN M CLARK (NPI# 1750449252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750449252 |
| Entity Type | Individual |
| Full Name | KATHRYN M CLARK |
| Credential | OD |
| Practice Address |
2101 Jacob St. Suite 201 Valley Prof. Center South Wheeling WV 26003-6390 |
| Mailing Address |
617 Glenhite Ave Wheeling WV 26003-6611 |
| Practice Telephone | 3042429245 |
| Practice Fax Number | 3042426870 |
| Mailing Telephone | 3042331482 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2011-05-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 831-OD | WV | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0149721000 | 05 | |
| OH | RAILROAD MEDICARE GROUP OH | DG5587 | 01 |
| WV | RAILROAD MEDICARE WV GROUP PIN | DG8768 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013467588 | Kathryn Jan Clark | Dentist | 4110 River Rd Nw, Washington, DC 20016-4618 | 2016-10-10 |
| 1568628535 | Kathryn Leigh Clark | Psychologist | 100 8th Ave, Brooklyn, NY 11215-1554 | 2008-07-30 |
| 1790861847 | Kathryn Marie Clark | Physical Therapist | 1 Peachtree Dr, Savannah, GA 31419-1200 | 2006-10-31 |
| 1992745954 | Kathryn M Clark | Dietitian, Registered | 221 Island Ave, Suite 101, San Diego, CA 92101-6936 | 2006-06-07 |
| 1013476928 | Kathryn Clark | Student in an Organized Health Care Education/Training Program | 1 Akron General Ave, Akron, OH 44307-2432 | 2019-03-19 |
| 1861978488 | Kathryn Clark | Anesthesiology | 200 1st St Sw, Rochester, MN 55905-0001 | 2018-07-17 |
| 1750898706 | Kathryn Evalyn Clark | Student in an Organized Health Care Education/Training Program | 600 North Wolfe Street, The Johns Hopkins Hospital, Baltimore, MD 21287 | 2017-12-29 |
| 1891193736 | Kathryn M Clark | Community Health Worker | 325 Sw Frazier Ave, Topeka, KS 66606-1963 | 2014-12-09 |
| 1821434317 | Kathryn Anne Clark | Counselor | 3716 Ne Martin Luther King Jr Blvd, Portland, OR 97212-1111 | 2013-05-11 |
| 1013292218 | Kathryn Clark | Pharmacist | 1000 Hugh Ward Blvd, Flowood, MS 39232-6600 | 2011-10-19 |
| Street Address |
2101 JACOB ST. SUITE 201 VALLEY PROF. CENTER SOUTH |
| City | WHEELING |
| State | WV |
| Zip Code | 26003-6390 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841351400 | Raymond A Bannan | Ophthalmology | 2101 Jacob St. Suite 201, Valley Prof. Center South, Wheeling, WV 26003-3800 | 2006-12-13 |
| 1548328875 | Raymond Anthony Bannan | Ophthalmology | 2101 Jacob St. Suite 201, Valley Prof Center South, Wheeling, WV 26003-6390 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070538 | Ashley Lynn Fleming | Case Manager/Care Coordinator | 442 Woodland Acres Rd, Wheeling, WV 26003 | 2020-10-13 |
| 1982202057 | Tiffany Renee Beck | Behavioral Analyst | 1007 Market Street, Wheeling, WV 26003 | 2020-10-12 |
| 1922620426 | Abbey Lynne Griffith | Speech-Language Pathologist | 199 Co Rd 7/7, Jane Lew, WV 26003 | 2020-05-07 |
| 1801309414 | Amy Wade | Counselor | 2204 Eoff Street, Wheeling, WV 26003 | 2017-11-06 |
| 1053840157 | Syl Solution Marketing | Durable Medical Equipment & Medical Supplies | 800 Hazlett Ave, Wheeling, WV 26003 | 2017-06-12 |
| 1568917334 | Hamed M Motlagh | Dentist | 53 14th St Ste 208, Wheeling, WV 26003 | 2016-08-22 |
| 1922454446 | Carrie Ann Warman | Pharmacist | 200 Mt.dechantal Road, Wheeling, WV 26003 | 2016-05-13 |
| 1447636691 | Ashley M Zando | Nurse Anesthetist, Certified Registered | 109 Mt Wood Road, Wheeling, WV 26003 | 2015-08-10 |
| 1194126441 | John Greaves | Specialist/Technologist | 135 Springdale Ave, Wheeling, WV 26003 | 2014-09-05 |
| 1154747210 | Donald Lee Rebich | Pharmacist | 61-29th Street, Wheeling, WV 26003 | 2014-03-13 |
| Find all providers in zip 26003 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902941974 | Michael S Michaels | Optometrist | 92 S. Milwaukee Ave, Wheeling, IL 90090 | 2007-02-20 |
| 1215071733 | Douglas Kent Graebe | Optometrist | 50 Washington Ave, Wheeling, WV 26003-6241 | 2007-02-17 |
| 1104962240 | Leonid Ayzenberg Md | Optometrist | 281 E Dundee Rd, Wheeling, IL 60090-3006 | 2007-01-29 |
| 1932183175 | Donald Raymond Taylor | Optometrist | 2106 Lumber Ave, Wheeling, WV 26003-5390 | 2005-12-01 |
| 1487645412 | Kenneth Portnoy | Optometrist | 727 W Dundee Rd, Wheeling, IL 60090-2605 | 2005-10-31 |
| 1821090184 | Joseph M. Bannon | Optometrist | 1021 National Rd, Wheeling, WV 26003-5779 | 2005-06-01 |
| 1306102082 | Jz Vision LLC | Optometrist | 342 S Milwaukee Ave, Wheeling, IL 60090-5021 | 2012-04-06 |
| 1750657110 | Affordable Optical of Wheeling,inc | Optometrist | 92 S. Milwaukee Ave, Wheeling, IL 60090 | 2012-03-29 |
| 1801183660 | Karina Nikogosian | Optometrist | 43 Huntington Ln, Wheeling, IL 60090-6908 | 2011-06-30 |
| 1639367980 | Dr.kenneth Portnoy Dba Pearle Vision | Optometrist | 727 W Dundee Rd, Wheeling, IL 60090-2605 | 2007-10-11 |
| Find all providers in WHEELING | ||||
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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.