MADISON RAE CLARK (NPI# 1821531492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821531492 |
| Entity Type | Individual |
| Full Name | MADISON RAE CLARK |
| Practice Address |
15413 E 3rd Ter S Independence MO 64050-2289 |
| Mailing Address |
411 Central Methodist Sq Fayette MO 65248-1104 |
| Practice Telephone | 8165855717 |
| Mailing Telephone | 8165855717 |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-12-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841645389 | Madison Clark | Marriage & Family Therapist | 11615 Northgate Trl, Roswell, GA 30075-2335 | 2016-05-03 |
| 1407195183 | Madison Anne Clark | Counselor | 711 W Main Street, Norman, OK 73069-6918 | 2013-01-31 |
| 1053950972 | Madison R Clark | Nurse Practitioner | 1275 York Ave, New York, NY 10065-6007 | 2019-12-23 |
| Street Address |
15413 E 3RD TER S |
| City | INDEPENDENCE |
| State | MO |
| Zip Code | 64050-2289 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841698024 | Joshonna Price | Occupational Therapy Assistant | 810 E Walnut, Independence, MO 64050 | 2014-12-19 |
| 1003151770 | Melinda Stegner | Registered Nurse | 3445 South 291 Hwy, Ste 300, Independence, MO 64050 | 2012-12-06 |
| 1194075788 | Healthstat- Independence School District | Preventive Medicine | 1516 W. Maple, Independence, MO 64050 | 2012-09-12 |
| 1568790749 | Charity Faith Morris | Case Manager/Care Coordinator | 314 E Pacific Avenue, Independence, MO 64050 | 2009-11-25 |
| 1225276090 | Best Smile, LLC | Dentist | 651 E 24 Hwy, Independence, MO 64050 | 2009-02-01 |
| 1396982468 | Independence Avenue Dental LLC | Clinic/Center | 1638 West 24 Highway, Independence, MO 64050 | 2009-01-12 |
| 1366640914 | Center for The Developmentally Disabled | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1215 W. Truman Rd, Independence, MO 64050 | 2007-07-05 |
| 1992871883 | Stephen Ervin Dorsch | Family Medicine | 1638 W 24 Hwy, Independence, MO 64050 | 2006-11-24 |
| 1831284801 | Ronald Eugene Jennings | Dentist | 514 S Noland Road, Noland Medical Plaza Suite 120, Independence, MO 64050 | 2006-10-04 |
| 1841393782 | Carmel Hills Healthcare and Rehabilitation Center, LLC | Skilled Nursing Facility | 810 East Walnut, Independence, MO 64050 | 2006-09-06 |
| Find all providers in zip 64050 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794025 | Linda M Widzinski | Student in an Organized Health Care Education/Training Program | 6490 Willow Dr, Independence, OH 44131-3226 | 2020-09-13 |
| 1013539659 | Mary Catherine Sammon | Student in an Organized Health Care Education/Training Program | 217 E Meadowlawn Blvd, Independence, OH 44131-2705 | 2020-05-16 |
| 1699394098 | Larry Ethan Milton | Student in an Organized Health Care Education/Training Program | 6664 Brecksville Rd, Independence, OH 44131-4841 | 2020-04-15 |
| 1023647617 | Emilie Seitz | Student in an Organized Health Care Education/Training Program | 6692 Renwood Rd, Independence, OH 44131-5317 | 2020-04-06 |
| 1457987703 | Cynthia Lauren Wright | Student in an Organized Health Care Education/Training Program | 4710 S Cedar Crest Ct Ste 200, Independence, MO 64055-6993 | 2020-03-18 |
| 1942764840 | Kelsey Ann Reid | Student in an Organized Health Care Education/Training Program | 1419 W Scott Pl, Independence, MO 64052-3134 | 2019-01-24 |
| 1679992721 | Alexander Stamos | Student in an Organized Health Care Education/Training Program | 3320 Saddle Ridge Ct, Independence, MO 64057-3407 | 2014-04-15 |
| 1760083844 | Andrew Regal | Student in an Organized Health Care Education/Training Program | 6000 Rockside Woods Blvd N, Independence, OH 44131-2330 | 2020-11-04 |
| 1902411291 | Rachel Sabrina Widzinski | Student in an Organized Health Care Education/Training Program | 6490 Willow Dr, Independence, OH 44131-3226 | 2020-09-13 |
| 1700434933 | Hana Rose Haselbusch | Student in an Organized Health Care Education/Training Program | 6200 Rockside Woods Blvd N Ste 305, Independence, OH 44131-2343 | 2019-08-30 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 64050 |
Please comment or provide details below to improve the information on MADISON RAE CLARK.
| 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.