MRS. KAILEY CLARK (NPI# 1912363946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912363946 |
| Entity Type | Individual |
| Full Name | MRS. KAILEY CLARK |
| Credential | ARNP-C |
| Practice Address |
4612 N Habana Ave Fl 2 Tampa FL 33614-7101 |
| Mailing Address |
2995 Drew St Fl 2 Clearwater FL 33759-3012 |
| Practice Telephone | 8138759000 |
| Practice Fax Number | 8138743278 |
| Mailing Telephone | 7275321355 |
| Mailing Fax Number | 8136352613 |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2020-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | ARNP9320963 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP 9320963 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 016597100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124630314 | Kailey Rae Clark | Audiologist | 700 19th St S, Birmingham, AL 35233-1927 | 2020-08-19 |
| Street Address |
4612 N HABANA AVE FL 2 |
| City | TAMPA |
| State | FL |
| Zip Code | 33614-7101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235343997 | Firas Suleiman Almahasneh | Internal Medicine | 4612 N Habana Ave Fl 2, Tampa, FL 33614-7101 | 2007-05-10 |
| 1477064988 | Misty B Swendryck | Nurse Practitioner | 4612 N Habana Ave Fl 2, Tampa, FL 33614-7101 | 2017-10-24 |
| 1467866996 | Melissia Michelle Seals | Nurse Practitioner | 4612 N Habana Ave Fl 2, Tampa, FL 33614-7101 | 2014-06-12 |
| 1366861189 | Piyush Vinayak Sovani | Internal Medicine | 4612 N Habana Ave Fl 2, Tampa, FL 33614-7101 | 2014-04-09 |
| 1144517335 | Anna Valina-toth | Internal Medicine | 4612 N Habana Ave Fl 2, Tampa, FL 33614-7101 | 2011-07-07 |
| 1811131311 | Gary M Idelchik | Internal Medicine | 4612 N Habana Ave Fl 2, Tampa, FL 33614-7101 | 2009-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733082 | Robin Rollena Stewart | Home Health | 9537 Lazy Lane, Apt 302, Tampa, FL 33614 | 2020-09-08 |
| 1346885761 | David Joseph Page | Nurse Practitioner | St. Joseph's Behavioral Health Center, 4918 N. Habana Ave, Tampa, FL 33614 | 2019-11-08 |
| 1134687411 | Ramon Chang Adult Family Care Home LLC | Custodial Care Facility | 2607 W Humphrey St, Tampa, FL 33614 | 2019-03-06 |
| 1134600612 | Senior Point Assisted Living Facility, LLC | Assisted Living Facility | 2940 W Hillsborough Ave, Tampa, FL 33614 | 2018-08-23 |
| 1306361266 | Larry Valdes | Assisted Living Facility | 4402 W Minnehaha St, Tampa, FL 33614 | 2017-08-11 |
| 1982128062 | Jaime F Casellas Md Corp | Internal Medicine | 4600 N Habana Ave Suit #13, Tampa, FL 33614 | 2017-07-31 |
| 1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
| 1750811857 | Syerita Nicole Morris | Counselor | 6800 N Dale Marby Hwy, Ste 164, Tampa, FL 33614 | 2017-06-13 |
| 1447786124 | Lisa Moy | Case Manager/Care Coordinator | 4001 W. Dr. Martin Luther King Jr. Blvd., Tampa, FL 33614 | 2017-05-02 |
| 1750813804 | Joshua Martin Good | Physical Therapy Assistant | 3363 W. Waters Avenue, Suite 700, Tampa, FL 33614 | 2017-03-29 |
| Find all providers in zip 33614 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356953905 | Mayelin Matos | Nurse Practitioner | 8320 W Pocahontas Ave, Tampa, FL 33615-2821 | 2020-08-17 |
| 1184235483 | Kety Uriarte | Nurse Practitioner | 4100 N Tampania Ave, Tampa, FL 33607-6830 | 2020-08-11 |
| 1861001919 | Deborah Diaz Telesford | Nurse Practitioner | 10709 Pleasant Knoll Dr, Tampa, FL 33647-3667 | 2020-07-24 |
| 1699392936 | Medjine Noel | Nurse Practitioner | 7412 French Marigold Ave, Tampa, FL 33619-6941 | 2020-07-02 |
| 1407472129 | Evisencia Mathurin | Nurse Practitioner | 9618 Oak Glade Ave, Tampa, FL 33647-2985 | 2020-06-18 |
| 1811518111 | Ji Universal Medical Group LLC | Nurse Practitioner | 8903 Regents Park Dr Ste 120, Tampa, FL 33647-3083 | 2020-04-28 |
| 1609414135 | Yaima Rodriguez | Nurse Practitioner | 7520 Brookhaven Ct, Tampa, FL 33634-2924 | 2019-12-16 |
| 1366087322 | Sajani Patel | Nurse Practitioner | 5210 Webb Rd Fl 33615, Tampa, FL 33615-4518 | 2019-11-14 |
| 1518501337 | Courtney Anne Sink | Nurse Practitioner | 10515 Villa View Cir, Tampa, FL 33647-2599 | 2019-11-05 |
| 1013472612 | Matthew Bragg | Nurse Practitioner | 13019 Delwood Rd, Tampa, FL 33624-4305 | 2019-02-07 |
| Find all providers in TAMPA | ||||
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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.