NICOLE CLARK (NPI# 1871968768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871968768 |
| Entity Type | Individual |
| Full Name | NICOLE CLARK |
| Credential | LAT, ATC |
| Practice Address |
332 Wilson Dr Bloomfield IN 47424-1054 |
| Practice Telephone | 3174323861 |
| Mailing Telephone | 3174323861 |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2015-12-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
36001806A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344826 | Nicole Clark | Home Health Aide | 1024 E 26th Ave, Columbus, OH 43211-2127 | 2020-10-26 |
| 1386106375 | Nicole Clark | Prosthetist | 100 N Burke Ave, Long Beach, MS 39560-4605 | 2019-04-01 |
| 1023513637 | Nicole Elizabeth Clark | Counselor | 3650 Ne Mallory Ave Apt 309, Portland, OR 97212-3086 | 2018-03-26 |
| 1619486834 | Nicole Clark | Registered Nurse | N4093 Keehn Rd, Winter, WI 54896-7312 | 2017-09-20 |
| 1285182022 | Nicole Michelle Clark | Social Worker | 1349 East Stroop Road, Dayton, OH 45429-4925 | 2016-09-21 |
| 1598165144 | Nicole Janine Clark | Behavioral Analyst | 1787 Village Ln N, Wantagh, NY 11793-3228 | 2014-09-02 |
| 1841609484 | Nicole Tm Clark | Emergency Medicine | 267 Ocean Ave, Portland, ME 04103-5707 | 2014-08-07 |
| 1851445670 | Nicole Ann Clark | Social Worker | 2051 S State St, Ann Arbor, MI 48104-4607 | 2007-01-22 |
| 1982767604 | Nicole Christine Clark | Licensed Practical Nurse | 241 Lorraine Ave, Syracuse, NY 13210-3229 | 2006-12-18 |
| 1760598411 | Nicole Anne Clark | Family Medicine | 475 W 940 N, Provo, UT 84604-3301 | 2006-08-22 |
| Street Address |
332 WILSON DR |
| City | BLOOMFIELD |
| State | IN |
| Zip Code | 47424-1054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528452281 | Kari Dawn Schulte | Specialist/Technologist | 246 E Simpson Chapel Rd, Bloomfield, IN 47424 | 2015-03-20 |
| 1316113376 | Sarah Elizabeth Flemming | Pediatrics | 55 N Judge St, Bloomfield, IN 47424 | 2008-04-30 |
| 1972696623 | Bloomfield School District | Local Education Agency (LEA) | 500 W South Street, Bloomfield, IN 47424 | 2006-10-02 |
| 1821585563 | Greene County General Hospital | Specialist | 55 N Judge St, Bloomfield, IN 47424 | 2018-04-18 |
| 1568730372 | Burton Chiropractic Clinic | Chiropractor | 505 S. Franklin St, Bloomfield, IN 47424-0424 | 2011-12-07 |
| 1538778139 | Tyralee Frye | Specialist/Technologist | 731 Lincoln Dr, Bloomfield, IN 47424-1023 | 2020-07-29 |
| 1881777258 | Ronald Jay Munden | Dentist | 124 E Indiana Ave, Bloomfield, IN 47424-1045 | 2006-10-21 |
| 1497388268 | Rb Munden, Dds, PC | Dentist | 124 E Indiana Ave, Bloomfield, IN 47424-1045 | 2020-02-19 |
| 1184006959 | Ronald Jay Munden, D.d.s. | Dentist | 124 E Indiana Ave, Bloomfield, IN 47424-1045 | 2015-06-29 |
| 1083947691 | Ryan Brant Munden | Dentist | 124 E Indiana Ave, Bloomfield, IN 47424-1045 | 2009-09-14 |
| Find all providers in zip 47424 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538778139 | Tyralee Frye | Specialist/Technologist | 731 Lincoln Dr, Bloomfield, IN 47424-1023 | 2020-07-29 |
| 1184182362 | John Caleb Maasin Reyes | Specialist/Technologist | 377 Broad St Apt 1, Bloomfield, NJ 07003-2782 | 2019-03-07 |
| 1003300260 | Kenny Laurent | Specialist/Technologist | 345 Hoover Ave, Bloomfield, NJ 07003-3918 | 2018-06-20 |
| 1932640919 | Lauren Mastrobuoni | Specialist/Technologist | 170 Liberty St, Bloomfield, NJ 07003 | 2017-03-10 |
| 1528452281 | Kari Dawn Schulte | Specialist/Technologist | 246 E Simpson Chapel Rd, Bloomfield, IN 47424 | 2015-03-20 |
| 1962824367 | Jenna L. Bidoglio | Specialist/Technologist | 1 Mount Vernon Ave, Apartment 2, Bloomfield, NJ 07003-3992 | 2014-01-20 |
| 1679775506 | Carl Adrian Payne | Specialist/Technologist | 467 Franklin St, Bloomfield, NJ 07003-3425 | 2007-06-04 |
| 1912556564 | Frederic Jimenez | Specialist/Technologist | 467 Franklin St, Bloomfield, NJ 07003-3494 | 2019-09-06 |
| 1922408293 | Jacqueline Cividanes | Specialist/Technologist | 467 Franklin St, Athletics Department, Bloomfield, NJ 07003-3425 | 2014-08-24 |
| 1033302609 | Brian Elliott | Specialist/Technologist | 510 Cottage Grove Rd, Bloomfield, CT 06002-3123 | 2007-08-27 |
| Find all providers in BLOOMFIELD | ||||
| City | BLOOMFIELD |
| Zip Code | 47424 |
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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.