BENJAMIN CLARK (NPI# 1851773196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851773196 |
| Entity Type | Individual |
| Full Name | BENJAMIN CLARK |
| Credential | M.D. |
| Practice Address |
3288 Moanalua Rd Honolulu HI 96819 |
| Mailing Address |
1 Jarrett White Rd Gme Office (mchk-he-me) Tripler Army Medical Center HI 96859-5001 |
| Practice Telephone | 3606283799 |
| Mailing Telephone | 3606283799 |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2018-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 19130 | HI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Jarrett White Rd, Gme Office (mchk-he-me), Tripler Army Medical Center, HI 968595001 | 3606283799 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548750110 | Benjamin Addril Clark | Pharmacist | Se Regional Pharmacy Attn: Ben Clark, 300 First Avenue South, Reidsville, GA 30453 | 2018-05-18 |
| 1285189704 | Benjamin Clark | Physical Therapist | 4501 Main St Ste 5, Shallotte, NC 28470-4585 | 2016-08-25 |
| 1275931479 | Benjamin Brian Clark | Physical Therapist | 7909 Forrest Ave, Belton, MO 64012-5303 | 2014-12-22 |
| 1831400894 | Benjamin T Clark | Family Medicine | 35945 N Gary Rd, San Tan Valley, AZ 85143-5748 | 2010-06-24 |
| 1497708572 | Benjamin S Clark | Nurse Practitioner | 1861 Main Street, Sneedville, TN 37869 | 2006-05-18 |
| 1598743627 | Benjamin Todd Clark | Dentist | 52 Medical Group, Unit 3690, Apo, AE 09126 | 2006-01-09 |
| 1730680232 | Benjamin Jonah Clark | Case Manager/Care Coordinator | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2018-02-21 |
| 1699180448 | Benjamin Allen Clark | Dentist | 1220 N Washington Ave, Durant, OK 74701-2120 | 2014-06-30 |
| 1790105674 | Benjamin Joseph Clark | Internal Medicine | 6431 Fannin St, Houston, TX 77030-1501 | 2014-04-18 |
| 1326321811 | Benjamin Paul Clark | Pharmacist | 2318 Frederica St, Owensboro, KY 42301-4826 | 2011-09-21 |
| Street Address |
3288 MOANALUA RD |
| City | HONOLULU |
| State | HI |
| Zip Code | 96819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556124 | Richard Edward Shields | Pharmacist | 3288 Moanalua Rd, Kaiser Permanente Hawaii, Honolulu, HI 96819 | 2005-05-24 |
| 1629681838 | Beatrice Xiaoying Huang | Pharmacist | 3288 Moanalua Rd, Honolulu, HI 96819-1469 | 2020-08-26 |
| 1962014274 | Melissa Kobayakawa | Pharmacist | 3288 Moanalua Rd, Honolulu, HI 96819-1469 | 2020-08-18 |
| 1952910325 | Ashley Mccormick | Pharmacist | 3288 Moanalua Rd, Honolulu, HI 96819-1469 | 2020-07-30 |
| 1891322863 | Elizabeth Mathew | Physical Therapist | 3288 Moanalua Rd, Honolulu, HI 96819-1469 | 2020-03-26 |
| 1548893456 | Dominique Lee | Student in an Organized Health Care Education/Training Program | 3288 Moanalua Rd, Honolulu, HI 96819-1469 | 2020-02-19 |
| 1861035230 | Mikaela Jazmin Pecson Sampayan | Pharmacist | 3288 Moanalua Rd, Honolulu, HI 96819-1469 | 2019-10-17 |
| 1598316820 | Ben Korthas | Radiology | 3288 Moanalua Rd, Honolulu, HI 96819-1469 | 2019-09-27 |
| 1033764808 | Rebecca Knight | Pharmacist | 3288 Moanalua Rd, Honolulu, HI 96819-1469 | 2019-08-07 |
| 1275187007 | Chelsea Tasaka | Pharmacist | 3288 Moanalua Rd, Honolulu, HI 96819-1469 | 2019-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619507621 | Corrie Sanders | Pharmacist | 450 Patterson Rd, Honolulu, HI 96819 | 2020-01-17 |
| 1245870526 | Ouida Searay Vaillancourt | Dental Hygienist | 339 Mongomery Ave, Honolulu, HI 96819 | 2020-01-14 |
| 1942852660 | Kolea Home Care | In Home Supportive Care | 2229 Kula Kolea Drive, Honolulu, HI 96819 | 2019-07-12 |
| 1164957882 | Kathleen Oliver | Student in an Organized Health Care Education/Training Program | 2229 North School St., Kokua Kalihi Valley Health Center, Honolulu, HI 96819 | 2017-05-01 |
| 1720436058 | Aaron Taniguchi | Physical Therapist | 1740 Ala Aolani St, Honolulu, HI 96819 | 2016-05-26 |
| 1770940892 | Tracy Lynne Khan Fernando | Nurse Practitioner | 2239 N. School St., Kokua Kalihi Valley, Honolulu, HI 96819 | 2016-01-20 |
| 1275961385 | Gavino T. Vinzons M.d, Inc | Family Medicine | 2055 N. King St. Ste 102, Honolulu, HI 96819 | 2013-10-29 |
| 1407195118 | Candace Adeline Schumacher | Licensed Vocational Nurse | 1460 Ala Aolani, Honolulu, HI 96819 | 2013-02-01 |
| 1750629556 | Benjamin L Kilinski | Nurse Practitioner | 1803 Kamehameha Iv Road, Honolulu, HI 96819 | 2013-01-29 |
| 1366701047 | Doreen Anela Oura Ramseyer | Case Manager/Care Coordinator | 1130 N. Nimitz Hwy., C-301, Honolulu, HI 96819 | 2012-05-15 |
| Find all providers in zip 96819 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619444569 | Optimized Health LLC | General Practice | 1441 Kapiolani Blvd Ste 1114, #23464, Honolulu, HI 96814 | 2018-10-30 |
| 1366926313 | Doctors of Waikiki | General Practice | 120 Kaiulani Ave Unit 10&11, Honolulu, HI 96815-6203 | 2018-09-15 |
| 1023517968 | Woundtech of Hawaii, Inc | General Practice | 120 Kaiulani Ave Ste 10-11, Honolulu, HI 96815-6203 | 2018-02-06 |
| 1285184796 | Summer Breeze LLC | General Practice | 4211 Waialae #202, Honolulu, HI 96816-5319 | 2016-10-07 |
| 1134540404 | Carolyn J. Mai | General Practice | 1522 Makaloa St, Suite 201, Honolulu, HI 96814-3255 | 2014-01-03 |
| 1316389828 | Robert Henry Nathanson | General Practice | 1520 Ward Ave, #602, Honolulu, HI 96822-3569 | 2013-07-25 |
| 1003156092 | Zhelah B Kayce | General Practice | 1009 Kapiolani Blvd, #4607, Honolulu, HI 96814-2112 | 2013-02-27 |
| 1366763567 | Samuel G Hawk | General Practice | 1345 S Beretania St Ste 101, Honolulu, HI 96814-1802 | 2010-06-22 |
| 1598992919 | Kimberly K Hooverson | General Practice | 1146 Fort Steeet Mall, Honolulu, HI 96813 | 2009-06-11 |
| 1982889028 | David Itsuo Miyauchi | General Practice | 970 Valley View Drive, Honolulu, HI 96819 | 2008-01-08 |
| Find all providers in HONOLULU | ||||
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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.