DR. JEREMY DEAN CLARK (NPI# 1902122443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902122443 |
| Entity Type | Individual |
| Full Name | DR. JEREMY DEAN CLARK |
| Credential | DO |
| Practice Address |
3901 W 15th St Plano TX 75075-7738 |
| Mailing Address |
1820 Preston Park Blvd Ste 1825 Plano TX 75093-3656 |
| Practice Telephone | 9725966800 |
| Mailing Telephone | 9728677862 |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2016-05-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Q7164 | TX | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982772042 | Jeremy Joseph Clark | Counselor | 71 Centennial Loop Ste A, Eugene, OR 97401-2443 | 2006-11-30 |
| 1356958383 | Jeremy Keith Clark | Marriage & Family Therapist | 1525 Lincoln Ave, Ogden, UT 84404-5638 | 2020-09-24 |
| 1912498338 | Jeremy James Clark | Nurse Practitioner | 1900 S Main St, Findlay, OH 45840 | 2018-05-21 |
| 1003334665 | Jeremy L. Clark | Nurse Practitioner | 985 9th Ave Sw Ste 307, Bessemer, AL 35022-7809 | 2017-09-05 |
| 1952747990 | Jeremy Clark | Counselor | 2086 Commerce Ave, Concord, CA 94520-4902 | 2013-05-17 |
| 1073838850 | Jeremy Dustin Clark | Ophthalmology | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | 2010-04-05 |
| 1851551873 | Jeremy Clark | Counselor | 2055 Garrett Way, Ste 1, Pocatello, ID 83201-5100 | 2008-06-12 |
| 1710018395 | Jeremy R Clark | Chiropractor | 100 N Kennedy Blvd, Vandalia, IL 62471-2314 | 2007-03-08 |
| 1588717417 | Jeremy J Clark | Obstetrics & Gynecology | 401 E Chestnut St, Suite 410, Louisville, KY 40202-5700 | 2007-01-22 |
| Street Address |
3901 W 15TH ST |
| City | PLANO |
| State | TX |
| Zip Code | 75075-7738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851394670 | Akilan Arumugham | Radiology | 3901 W 15th St, Plano, TX 75075-7738 | 2005-05-24 |
| 1568071108 | Tessa Thibodeaux | Nurse Practitioner | 3901 W 15th St, Plano, TX 75075-7738 | 2020-07-29 |
| 1225663867 | North Texas Gi Hospitalists, LLC | Internal Medicine | 3901 W 15th St, Plano, TX 75075-7738 | 2020-03-04 |
| 1801426408 | Lesley George | Pharmacist | 3901 W 15th St, Plano, TX 75075-7738 | 2020-01-22 |
| 1700416989 | James J Rockefeller Md, Pllc | Anesthesiology | 3901 W 15th St, Plano, TX 75075-7738 | 2020-01-16 |
| 1376187682 | Tabtiha Jean Inge | Nurse Practitioner | 3901 W 15th St, Plano, TX 75075-7738 | 2019-10-30 |
| 1528616042 | Lighthouse Anesthesia Pllc. | Anesthesiology | 3901 W 15th St, Plano, TX 75075-7738 | 2019-08-28 |
| 1962058636 | Halen Benjamin | Nurse Practitioner | 3901 W 15th St, Plano, TX 75075-7738 | 2019-08-17 |
| 1730731142 | Shelby Jane Smith | Nurse Practitioner | 3901 W 15th St, Plano, TX 75075-7738 | 2019-07-15 |
| 1033761630 | Simon Kaitei | Nurse Practitioner | 3901 W 15th St, Plano, TX 75075-7738 | 2019-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861027120 | North Star Mcd, LLC | Clinic/Center | 3700 W 15th St Bldg D Ste 200, Plano, TX 75075 | 2020-03-06 |
| 1558991364 | Pinner Hio Chiropractic, Inc | Chiropractor | 3801 George Bush Turnpike, Ste 130, Plano, TX 75075 | 2020-01-21 |
| 1396214052 | Tu Cam Bui Forkner | Physician Assistant | 3804 W 15th St Ste 140, Plano, TX 75075 | 2018-11-24 |
| 1033691498 | Jane Njeri Muchiri | Licensed Vocational Nurse | 1255 West 15th Street Suite1025, Plano, TX 75075 | 2018-09-02 |
| 1548742976 | Bethany Noelle Bell | Speech-Language Pathologist | 1255 W 15th Street Suite 1025, Plano, TX 75075 | 2018-09-01 |
| 1639650302 | Olufunke Oloyede | Licensed Vocational Nurse | 1255 W 15th St Ste 1205, Plano, TX 75075 | 2018-08-22 |
| 1679053995 | Healthrx Pharmacy LLC | Pharmacy | 2235 W 15th St, Plano, TX 75075 | 2018-08-16 |
| 1134606593 | Lauren Scurry | Speech-Language Pathologist | 2809 Hunters Creek, Plano, TX 75075 | 2018-07-27 |
| 1740767946 | Barikat Aruna Oderinde | Nurse Practitioner | 804 Edmonton Dr, Plano, TX 75075 | 2018-07-20 |
| 1932685302 | Surgical Anesthesia Consultants, Pllc | Anesthesiology | 2419 Coit Road, Suite B, Plano, TX 75075 | 2018-07-18 |
| Find all providers in zip 75075 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780246561 | Imaging Consultants | Radiology | 7250 Dallas Pkwy Ste 400, Plano, TX 75024-4931 | 2019-07-02 |
| 1487996310 | Medical Diagnostic Imaging Group, Ltd. | Radiology | 4809 Pyramid Dr, Plano, TX 75093-1913 | 2013-03-18 |
| 1811039381 | University of Texas Southwestern Medical Center At Dallas | Radiology | 7609 Preston Rd, Plano, TX 75024-3214 | 2007-02-13 |
| 1306923404 | Rodney Vaughn Peveto | Radiology | 6632 Winged Foot Way, Plano, TX 75093-6368 | 2006-11-01 |
| 1356359863 | Bruce Alan Cheatham | Radiology | 2624 Polo Ln, Plano, TX 75093-4772 | 2006-08-03 |
| 1376569178 | Steven Steinbaum | Radiology | 4216 Donnington Dr, Plano, TX 75093-3858 | 2006-07-14 |
| 1003846841 | Irving Radiological Associates LLP | Radiology | 2301 Marsh Lane, Plano, TX 75093-8497 | 2006-07-04 |
| 1194751685 | Paul Timothy Staveteig | Radiology | 1820 Preston Park Blvd Ste 1200, Plano, TX 75093-5293 | 2006-06-25 |
| 1497781900 | Kan Ying | Radiology | 1820 Preston Park Blvd Ste 1825, Plano, TX 75093-5215 | 2006-06-25 |
| 1871536151 | Mark A Baker | Radiology | 6957 W Plano Pkwy Ste 1100, Plano, TX 75093-1621 | 2006-06-14 |
| Find all providers in PLANO | ||||
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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.