JENNIFER L. CLARK (NPI# 1861819716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861819716 |
| Entity Type | Individual |
| Full Name | JENNIFER L. CLARK |
| Credential | M.D. |
| Practice Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Mailing Address |
75 Francis St Boston MA 02115-6110 |
| Practice Telephone | 5087936100 |
| Practice Fax Number | 5087936110 |
| Mailing Telephone | 6177327510 |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2019-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
277023 | MA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932723038 | Jennifer Michelle Clark | Social Worker | 22 Norva Ave, Frederick, MD 21701-6279 | 2020-06-04 |
| 1982249926 | Jennifer Rae Clark | Nurse Practitioner | 2800 E League City Pkwy Apt 216, League City, TX 77573-1676 | 2019-11-13 |
| 1528546827 | Jennifer Clark | Technician | 59 Forrester St Sw Apt B, Washington, DC 20032-2120 | 2018-07-30 |
| 1265940340 | Jennifer Anne Clark | Counselor | 35 Pulaski Rd, Whitehouse Station, NJ 08889-3516 | 2018-01-11 |
| 1598118572 | Jennifer Clark | Internal Medicine | 1120 W. Michigan Street Gatch Hall Cl 630, Indianapolis, IN 46204 | 2016-07-14 |
| 1295124899 | Jennifer Clark | Behavioral Analyst | 662 Lake George Dr, Melbourne, FL 32940-2221 | 2015-01-20 |
| 1851707194 | Jennifer Sara Clark | Physical Therapist | 797 Evergreen Dr, West Hempstead, NY 11552-3406 | 2014-07-08 |
| 1083988794 | Jennifer Makiki Clark | Health Educator | 5858 Wilshire Blvd Ste 300, Los Angeles, CA 90036-4509 | 2012-02-27 |
| 1639484520 | Jennifer Ann Clark | Speech-Language Pathologist | 5903 Neptune Dr, Fort Collins, CO 80525-3905 | 2010-08-16 |
| 1245567247 | Jennifer Selleck Clark | Nurse Practitioner | 1840 Martin Luther King Jr Blvd Ste C4, Chapel Hill, NC 27514 | 2009-11-11 |
| Street Address |
55 LAKE AVE N |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720286370 | Mark Davis | Pathology | 1 Innovation Dr Ste 3, Worcester, MA 01605-4306 | 2007-07-05 |
| 1629464334 | Stephanie Petkiewicz | Pathology | 1 Innovation Dr, Biotech 3, Worcester, MA 01605-4307 | 2015-04-09 |
| 1316332398 | Hiba Ibrahim | Pathology | 55 Lake Ave N, Worcester, MA 01655-0002 | 2015-04-06 |
| 1154754372 | Ali Sakhdari | Pathology | 1 Innovation Dr, Biotech 3, Worcester, MA 01605-4307 | 2013-08-12 |
| 1235492513 | Qingqing Liu | Pathology | 1 Innovation Dr Ste 3, Worcester, MA 01605-4306 | 2012-06-21 |
| 1740541051 | Amy G Zhou | Pathology | 55 Lake Ave N, Worcester, MA 01655-0002 | 2012-06-04 |
| 1568723864 | Rebecca E Dedrick | Pathology | 55 Lake Ave N, Worcester, MA 01655-0002 | 2012-06-04 |
| 1427336056 | Parnian Ahmadi Moghaddam | Pathology | 1 Innovation Dr, Biotech 3, Worcester, MA 01605-4307 | 2011-08-01 |
| 1346534609 | Wei Xing | Pathology | 1 Innovation Dr, Biotech 3, Worcester, MA 01605-4307 | 2011-06-04 |
| 1093006918 | Minoti Magotra | Pathology | 1 Innovation Dr, Biotech 3, Worcester, MA 01605-4307 | 2011-04-26 |
| Find all providers in WORCESTER | ||||
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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.