MS. MARY OLIVIA CLARK (NPI# 1821541152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821541152 |
| Entity Type | Individual |
| Full Name | MS. MARY OLIVIA CLARK |
| Other Name | OLIVIA CLARK |
| Credential | PA |
| Practice Address |
2142 W Broad St Bldg 100 Ste 200 Athens GA 30606-3506 |
| Mailing Address |
Po Box 48089 Athens GA 30604-8089 |
| Practice Telephone | 7065486881 |
| Practice Fax Number | 7065460821 |
| Mailing Telephone | 7063893740 |
| Mailing Fax Number | 7063893951 |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2019-06-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958252 | Mary Beth Clark | Speech-Language Pathologist | 18 La Salle Ave, Sioux City, IA 51104-2412 | 2020-06-25 |
| 1205461266 | Mary Clark | Nurse's Aide | 229 Elmhurst Rd, Dayton, OH 45417-1420 | 2020-03-10 |
| 1366981839 | Mary Clark | Acupuncturist | 8380 Six Forks Rd Ste 203, Raleigh, NC 27615-5091 | 2017-02-16 |
| 1740698935 | Mary Christine Clark | Lactation Consultant, Non-RN | 2774 230th St, Cushing, WI 54006-3421 | 2014-07-31 |
| 1982022562 | Mary Clark | Non-emergency Medical Transport (VAN) | 2957 Brogdon Rd, Alcolu, SC 29001-8637 | 2014-04-01 |
| 1760825392 | Mary Elizabeth Clark | Doula | 8634 Oakside Ave, Commerce Township, MI 48382-3763 | 2013-04-13 |
| 1336497460 | Mary Clark | Chiropractor | 298 Federal Hill Rd, Milford, NH 03055-3553 | 2012-08-21 |
| 1730460098 | Mary Jo Clark | Specialist | 2691 Highway 62 412, Highland, AR 72542-9479 | 2011-08-31 |
| 1649559410 | Mary Jackson Clark | Counselor | 904 Washington Rd Ste A, Westminster, MD 21157-5838 | 2011-08-11 |
| 1952691461 | Mary Denise Clark | Doula | 1070 Milo Cir Apt B, Lafayette, CO 80026-3089 | 2011-04-18 |
| Street Address |
2142 W BROAD ST BLDG 100 STE 200 |
| City | ATHENS |
| State | GA |
| Zip Code | 30606-3506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902804784 | Gary Richard Walton | Urology | 2142 W Broad St, Building 200, Suite 200, Athens, GA 30606-3506 | 2005-07-14 |
| 1770096034 | Rachel Victoria Treadwell | Nurse Practitioner | 2142 W Broad St, Athens, GA 30606 | 2017-11-08 |
| 1619428653 | Aubrey Trujillo | Nurse Practitioner | 2142 W Broad St, Bldg 100 Ste 200, Athens, GA 30606-3506 | 2016-10-14 |
| 1275985053 | Athens Area Urology- Ellison, Walton, and Byrne | Nurse Practitioner | 2142 W Broad St, Building 200, Suite 200, Athens, GA 30606-3506 | 2016-07-06 |
| 1659763035 | Jaime Barrera | Nurse Practitioner | 2142 W Broad St, Bldg 200 Ste 200, Athens, GA 30606-3506 | 2015-02-23 |
| 1346663192 | Joseph Nathaniel Ingle | Physician Assistant | 2142 W Broad St, Bldg 100, Ste 200, Athens, GA 30606-3506 | 2014-01-30 |
| 1013256643 | Matthew David Kellar | Physical Therapist | 2142 W Broad St, Bldg 100, Ste 200, Athens, GA 30606-3506 | 2013-02-01 |
| 1427315845 | Traci Johns | Nurse Practitioner | 2142 W Broad St, Building 200, Suite 200, Athens, GA 30606-3506 | 2012-04-23 |
| 1508135658 | Surgery Center of Athens LLC | Clinic/Center | 2142 W Broad St, Suite 100, Athens, GA 30606-3546 | 2011-12-19 |
| 1760750137 | Kaiser Permanente | Clinical Medical Laboratory | 2142 W Broad St, Bldg 200, Athens, GA 30606-3546 | 2011-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816962 | Kofi Darkwa Seffah | Student in an Organized Health Care Education/Training Program | 1199 Prince Ave #70, 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-09-16 |
| 1831712363 | Rebecca John | Licensed Practical Nurse | 240 Mitchel Bridge Road, Athens, GA 30606 | 2020-05-19 |
| 1497375612 | Alfred Ka-shing Wong | Student in an Organized Health Care Education/Training Program | 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-04-17 |
| 1881223956 | Lauren Fesperman | Nurse Practitioner | 242 King Ave Ste 130, Athens, GA 30606 | 2020-04-02 |
| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1255981700 | Carol Cameron Cready-pyle | Social Worker | 1551 Jennings Mill Pkwy Ste 1700, Athens, GA 30606 | 2019-09-17 |
| 1013576016 | Lauren Gruendling | Nurse Practitioner | 242 King Avenue, Suite 210, Athens, GA 30606 | 2019-06-12 |
| 1760045223 | Dominic Ofosu Amakye | Student in an Organized Health Care Education/Training Program | 1270 Prince Avenue Suite 201, Athens, GA 30606 | 2019-04-19 |
| 1740740422 | Juan G Salazar Castillo | Student in an Organized Health Care Education/Training Program | Community Internal Medicine of Athens, 1500 Oglethorpe Ave Suite 200d, Athens, GA 30606 | 2019-03-20 |
| 1750869020 | Jennifer Emily Chapman | Physical Therapist | 1021 Parkway Blvd Ste 101, Athens, GA 30606 | 2018-07-30 |
| Find all providers in zip 30606 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003257163 | Kalen Elizabeth Ashford | Physician Assistant | 1061 Dowdy Rd Ste 202, Athens, GA 30606-5700 | 2013-07-17 |
| 1427367192 | Julie Michelle Key | Physician Assistant | 1270 Prince Avenue Suite 103, Athens, GA 30606 | 2010-09-29 |
| 1992740682 | Heather Coates | Physician Assistant | 135 N Meadows Dr, Suite B, Athens, TN 37303-4172 | 2006-06-18 |
| 1922046267 | Rishia L Brown | Physician Assistant | 1480 Baxter St Ste A, Athens, GA 30606 | 2006-06-02 |
| 1598370553 | Olivia James | Physician Assistant | 2 Health Center Dr, Athens, OH 45701-2907 | 2020-09-15 |
| 1114548559 | Kristina Louise Kauffman | Physician Assistant | 2142 W Broad St Ste 200, Athens, GA 30606-3506 | 2020-04-27 |
| 1124501184 | Anna Cauthen Mcfather | Physician Assistant | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2018-09-14 |
| 1013498849 | Mary Rougeau Browning | Physician Assistant | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2018-08-29 |
| 1881072379 | Athens Associates In Family Practice | Physician Assistant | 300 Hawthorne Ln, Athens, GA 30606-2152 | 2015-05-15 |
| 1821480450 | Meagan Meekin Rector | Physician Assistant | 2142 W Broad St Ste 200, Athens, GA 30606 | 2015-02-18 |
| Find all providers in ATHENS | ||||
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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.