SHANNON DENISE CLARK (NPI# 1881726271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881726271 |
| Entity Type | Individual |
| Full Name | SHANNON DENISE CLARK |
| Other Name | SHANNON DENISE LARGE |
| Credential | CNP |
| Practice Address |
2 Easton Oval Ste 450 Columbus OH 43219-6035 |
| Practice Telephone | 6144759500 |
| Practice Fax Number | 6144759821 |
| Mailing Telephone | 6144759500 |
| Mailing Fax Number | 6144759821 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2018-12-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN.CNP.023853 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| N | 3747A0650X |
Technician Specialization: Attendant Care Provider |
RN-253819 | OH | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2716887 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8256 Harrisburg Rd, Orient, OH 431469528 | 6148773631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366931552 | Shannon Clark | Registered Nurse | 8201 S 61st St, Lincoln, NE 68516-5994 | 2018-05-03 |
| 1457786675 | Shannon Clark | Occupational Therapy Assistant | 860 W 132nd Ave, Spc 268, Westminster, CO 80234-1499 | 2013-09-06 |
| 1760537617 | Shannon Renee Clark | Nurse Practitioner | 3128 Santa Rita Rd, Suite C, Pleasanton, CA 94566-8300 | 2007-01-23 |
| 1700940855 | Shannon Jackie Clark | Contractor | 10750 S Knoll Crest Ln, Tucson, AZ 85706-9052 | 2006-12-21 |
| 1720089311 | Shannon Lynn Clark | Chiropractor | 423 Main St, Reinbeck, IA 50669-1049 | 2005-08-03 |
| 1487149373 | Shannon Clark | Counselor | 90 Hospital Dr, Athens, OH 45701-2301 | 2018-06-25 |
| 1679021448 | Shannon Lorraine Clark | Speech-Language Pathologist | 2251 E Paris Ave Se, Grand Rapids, MI 49546-2431 | 2016-09-21 |
| 1508299777 | Shannon Joan Clark | Nurse Practitioner | 3604 Bush St, Raleigh, NC 27609-7511 | 2013-08-12 |
| 1770916033 | Shannon M Clark | Specialist/Technologist, Other | 3 Maryland Farms Ste 200, Brentwood, TN 37027-5780 | 2013-08-09 |
| 1700147436 | Shannon Clark | Day Training/Habilitation Specialist | 200 General St, Batesville, AR 72501-9407 | 2012-05-29 |
| Street Address |
2 EASTON OVAL STE 450 |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43219-6035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965651 | Abigail Hope Judge | Social Worker | 2 Easton Oval Ste 450, Columbus, OH 43219-6035 | 2020-06-02 |
| 1851920490 | Lauren Anne Wright | Psychologist | 2 Easton Oval Ste 450, Columbus, OH 43219-6035 | 2020-04-06 |
| 1164906475 | Adina Tzila Bitton | Psychologist | 2 Easton Oval Ste 450, Columbus, OH 43219-6035 | 2018-09-21 |
| 1861989667 | Kayi Hui-spears | Psychologist | 2 Easton Oval Ste 450, Columbus, OH 43219-6035 | 2018-04-17 |
| 1891298188 | Daeylin Rock | Counselor | 2 Easton Oval Ste 450, Columbus, OH 43219 | 2018-03-13 |
| 1861641268 | Nicolette Lurissa Howells | Psychologist | 2 Easton Oval Ste 450, Columbus, OH 43219-6035 | 2008-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430844 | Pdq Transportation Inc | Secured Medical Transport (VAN) | 1640 E 5th Ave, Columbus, OH 43219 | 2020-06-06 |
| 1366066599 | Urban Limousine LLC | Secured Medical Transport (VAN) | 1640 E. 5th Ave, Columbus, OH 43219 | 2020-06-03 |
| 1841757879 | Camille Cook | Nurse Practitioner | 4200 Regent St. Suite 200, Columbus, OH 43219 | 2019-02-26 |
| 1164904595 | Vida Yeboah | Registered Nurse | 2320 Doneen Dr, Columbus, OH 43219 | 2018-09-01 |
| 1407373129 | Chevon Marie Wiseman | Nurse's Aide | 2835 Jared Pl, Columbus, OH 43219 | 2017-08-23 |
| 1952826737 | Hilary Schadle Demostenes | Social Worker | 2780 Airport Dr, Suite 100 - Billing/credentialing Dept., Columbus, OH 43219 | 2017-08-14 |
| 1851833800 | Amanda Yahn | Student in an Organized Health Care Education/Training Program | 2469 Stelzer Road, Bradford School, Columbus, OH 43219 | 2016-11-08 |
| 1215312939 | Taylor Weary | Student in an Organized Health Care Education/Training Program | 2649 Stelzer Rd, Columbus, OH 43219 | 2015-07-23 |
| 1568846715 | Brenton Semplak | Student in an Organized Health Care Education/Training Program | 2469 Stelzer Rd., Columbus, OH 43219 | 2015-07-17 |
| 1811384746 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 4142 Seward Street, Suite F105, Columbus, OH 43219 | 2015-04-17 |
| Find all providers in zip 43219 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548873680 | Nicollette Pizzoferrato | Nurse Practitioner | 600 W Goodale St Apt 261, Columbus, OH 43215-1904 | 2020-08-28 |
| 1750994125 | Soumi Dey | Nurse Practitioner | 2085 Citygate Dr, Columbus, OH 43219-3656 | 2020-08-26 |
| 1063024065 | Tanna Lynn Lok | Nurse Practitioner | 4545 Fisher Rd, Columbus, OH 43228-8923 | 2020-08-20 |
| 1548878937 | Tracy King | Nurse Practitioner | 2561 Bryden Rd, Columbus, OH 43209-2135 | 2020-07-21 |
| 1598386641 | Brina Nakia Smith | Nurse Practitioner | 3 Kingsridge Ct, Columbus, GA 31907-3730 | 2020-04-29 |
| 1770111361 | Donna Betty Mitchell | Nurse Practitioner | 48 Northstar Dr, Columbus, GA 31907-6348 | 2020-03-30 |
| 1124653514 | William A Jansak | Nurse Practitioner | The Richard M. Ross Heart Hospital, 4th Floor, 452 West 10th Ave, Columbus, OH 43210 | 2020-03-06 |
| 1164073227 | Victoria Hargrove | Nurse Practitioner | 2473 Highway 69 S, Columbus, MS 39702-9248 | 2019-09-20 |
| 1700431657 | Ohio Tms Clinic LLC | Nurse Practitioner | 3099 Sullivant Ave, Columbus, OH 43204-1895 | 2019-08-07 |
| 1780238204 | Gail Lorine Jones | Nurse Practitioner | 820 Brookstone Centre Pkwy # Ga31904, Columbus, GA 31904-9246 | 2019-08-01 |
| Find all providers in COLUMBUS | ||||
Please comment or provide details below to improve the information on SHANNON DENISE 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.