JESSICA CLARK (NPI# 1982198610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982198610 |
| Entity Type | Individual |
| Full Name | JESSICA CLARK |
| Credential | DNP, PMHNP-BC |
| Practice Address |
1791 Alum Creek Dr Columbus OH 43207-1757 |
| Mailing Address |
765 Pierce Dr Columbus OH 43223-2425 |
| Practice Telephone | 6144458131 |
| Mailing Telephone | 6142236150 |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2020-09-26 |
| NPI Deactivation Date | 09/02/2020 |
| NPI Reactivation Date | 2020-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0807X |
Registered Nurse Specialization: Psych/Mental Health, Child & Adolescent |
RN.438874 | OH | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN.CNP.0027330 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 1962855452 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528690906 | Jessica Clark | Doula | 343 N Main Ave, Gresham, OR 97030-7246 | 2020-02-04 |
| 1962054387 | Jessica Lynn Clark | Nurse Practitioner | 7219 N Litchfield Rd Bldg 11302nd, Luke Air Force Base, AZ 85309-1529 | 2019-07-16 |
| 1568962306 | Jessica Lee Clark | Registered Nurse | 6011 Cielo Rnch, San Antonio, TX 78218-4161 | 2018-02-19 |
| 1811416076 | Jessica Clark | Counselor | 42189 Shadow Creek Ave, Gonzales, LA 70737-7241 | 2017-09-19 |
| 1124572821 | Jessica Clark | Specialist | 5664 Cahuenga Blvd, North Hollywood, CA 91601-2103 | 2016-08-10 |
| 1104286871 | Jessica Clark | Counselor | 2575 Westgate Bldg 2, Pendleton, OR 97801-9613 | 2016-02-24 |
| 1942612296 | Jessica Clark | Case Management | 620 John Austin Ln, Mt Washington, KY 40047-6354 | 2014-05-21 |
| 1154610269 | Jessica Clark | Social Worker | 55 Floyd Ave, Riverside, RI 02915-2927 | 2011-03-30 |
| 1346558780 | Jessica Clark | Dietitian, Registered | 187-191 Main Street, Ste 300, Emmaus, PA 18049-4017 | 2010-09-20 |
| 1760794309 | Jessica Michelle Clark | Dentist | 1300 Kempsville Rd Ste 5, Virginia Beach, VA 23464-6199 | 2010-07-12 |
| Street Address |
1791 ALUM CREEK DR |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43207-1757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245290436 | Maryhaven Inc. | Clinic/Center | 1791 Alum Creek Dr, Columbus, OH 43207-1708 | 2006-03-23 |
| 1073111605 | Melinda Swank | Social Worker | 1791 Alum Creek Dr, Columbus, OH 43207-1708 | 2020-10-15 |
| 1154937225 | Victoria Rose George | Social Worker | 1791 Alum Creek Dr, Columbus, OH 43207-1708 | 2020-09-23 |
| 1023624616 | Annis Spence | Case Manager/Care Coordinator | 1791 Alum Creek Dr, Columbus, OH 43207-1757 | 2020-09-18 |
| 1639781131 | Ann Christine Redman | Social Worker | 1791 Alum Creek Dr, Columbus, OH 43207-1757 | 2020-08-18 |
| 1073121174 | Gram Christian Royal | Counselor | 1791 Alum Creek Dr, Columbus, OH 43207-1757 | 2020-07-15 |
| 1376161893 | Patrick Mensah | Registered Nurse | 1791 Alum Creek Dr, Columbus, OH 43207-1708 | 2020-07-10 |
| 1306463369 | Allison Skinner | Social Worker | 1791 Alum Creek Dr, Columbus, OH 43207-1708 | 2020-06-25 |
| 1659997369 | Caileigh Chadwick | Social Worker | 1791 Alum Creek Dr, Columbus, OH 43207-1708 | 2020-06-18 |
| 1689295313 | Melanie Jayne Barnes | Case Manager/Care Coordinator | 1791 Alum Creek Dr, Columbus, OH 43207-1757 | 2020-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366947913 | Mary Elise Hanks | Internal Medicine | Osumc/nationwide Children's Med-ped Residency Program, 1405 S. High St, Columbus, OH 43207 | 2018-03-27 |
| 1699279323 | Timothy Ming-li Pian | Internal Medicine | Internal Medicine-pediatric Residency Program, 1405 S. High Street, Columbus, OH 43207 | 2018-03-19 |
| 1093245763 | Royce Scott | Home Health | 254 E. Barthman Ave, Columbus, OH 43207 | 2017-06-15 |
| 1497207930 | Vernon C Murphy Jr. | Counselor | 1430 S High St Suite 112, Columbus, OH 43207 | 2016-11-01 |
| 1669825931 | Ayamba Roselyn Tanyi | Social Worker | 1791 Alum Creek Drive, Columbus, OH 43207 | 2016-07-21 |
| 1629421268 | Tiffany Dawn Hinkle | Counselor | 1430 S. High St, Suite 112, Columbus, OH 43207 | 2016-07-19 |
| 1457714933 | Matthew Isaac Lyons | Internal Medicine | 1405 S. High St., Osu/nch Internal Medicine-pediatric Residency Prog., Columbus, OH 43207 | 2016-04-01 |
| 1053712976 | A Plus Children's Academy Community School | Local Education Agency (LEA) | 110 Obetz Rd., Columbus, OH 43207 | 2014-09-10 |
| 1407274301 | William Hamilton Marshall V | Student in an Organized Health Care Education/Training Program | 1405 South High St, South High Primary Care Center, Columbus, OH 43207 | 2014-03-29 |
| 1912249665 | Laura Romcevich | Internal Medicine | 700 Children's Dr. Ed650a, Osu/nch Internal Medicine-pediatric Residency Prog., Columbus, OH 43207 | 2013-03-20 |
| Find all providers in zip 43207 | ||||
| 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 | ||||
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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.