NISSE VIRGINIA CLARK (NPI# 1982967105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982967105 |
| Entity Type | Individual |
| Full Name | NISSE VIRGINIA CLARK |
| Credential | M.D. |
| Practice Address |
55 Fruit St Boston MA 02114-2621 |
| Mailing Address |
800 Washington St Boston MA 02111-1552 |
| Practice Telephone | 6177246850 |
| Mailing Telephone | 6176365000 |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2018-04-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 252130 | MA | Allopathic & Osteopathic Physicians |
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
265956 | MA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 55 Fruit St # 4, Boston, MA 021142621 | 6177246850 | |
| 800 Washington St, Boston, MA 021111552 | 6176365000 |
| Street Address |
55 FRUIT ST |
| City | BOSTON |
| State | MA |
| Zip Code | 02114-2621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568465888 | Michael A Nichols | Nurse Anesthetist, Certified Registered | 55 Fruit St, Boston, MA 02114-2696 | 2005-05-31 |
| 1740881374 | Katelyn Mary Bushey | Clinical Nurse Specialist | 55 Fruit St, Boston, MA 02114-2696 | 2020-11-02 |
| 1316546849 | Amy Lauren Greenblatt | Student in an Organized Health Care Education/Training Program | 55 Fruit St, Boston, MA 02114-2696 | 2020-10-26 |
| 1134728116 | Stephanie Qualls | Student in an Organized Health Care Education/Training Program | 55 Fruit St, Boston, MA 02114-2621 | 2020-10-21 |
| 1811596190 | Andrea S Hansen | Clinical Nurse Specialist | 55 Fruit St, Boston, MA 02114-2696 | 2020-10-19 |
| 1649879974 | Barbara Healy | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2696 | 2020-10-19 |
| 1770181117 | Molly Cristina Reynolds | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2621 | 2020-10-16 |
| 1245838325 | Katerina Eleni Kafkas | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2621 | 2020-10-12 |
| 1578179040 | Vivian Ellen Donahue | Registered Nurse | 55 Fruit St, Boston, MA 02114-2696 | 2020-09-21 |
| 1699380956 | Joanne Gover | Registered Nurse | 55 Fruit St, Boston, MA 02114-2621 | 2020-09-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
| 1881223741 | Alexander Wesley Zirulnik | Student in an Organized Health Care Education/Training Program | 55 Fruit St. Boston, Boston, MA 02114 | 2020-04-03 |
| 1376170548 | Mia Yu Bothwell | Student in an Organized Health Care Education/Training Program | Gray Bigelow 730, 55 Fruit Street, Boston, MA 02114 | 2020-03-26 |
| 1225661036 | David Dongkyung Kim | Student in an Organized Health Care Education/Training Program | 6 Whittier Place, Apartment 15b, Boston, MA 02114 | 2020-02-20 |
| 1124651658 | Madeleine Sertic | Student in an Organized Health Care Education/Training Program | Division of Abdominal Imaging, Department of Radiology, 55 Fruit Street, White 270, Boston, MA 02114 | 2020-02-12 |
| 1285274498 | Jiuk James Jung | Student in an Organized Health Care Education/Training Program | 15 Parkman Ave, Wang 4-460, Boston, MA 02114 | 2020-01-15 |
| 1831740448 | Jennifer Hughes | Physician Assistant | 55 Fruit Street, Founders 110, Boston, MA 02114 | 2019-09-25 |
| 1558827220 | Aluma Chovel Sella | Student in an Organized Health Care Education/Training Program | Massgeneral Hospital for Children Main Campus, 55 Fruit Street, Boston, MA 02114 | 2019-02-18 |
| 1083187140 | Henry Oliveras | Massage Therapist | 102 Charles Street, Boston, MA 02114 | 2019-01-10 |
| 1720550031 | Nicole M Price | Social Worker | 29 Staniford St, Boston, MA 02114 | 2018-12-27 |
| Find all providers in zip 02114 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013925015 | Toni Beth Walzer | Obstetrics & Gynecology | 333 Longwood Avenue, Adolescent Gynecology, Boston, MA 02115 | 2006-08-04 |
| 1508824400 | Kenneth L Noller | Obstetrics & Gynecology | Box 324, Washington St., New England Medical Center, Boston, MA 02111 | 2006-05-02 |
| 1861955114 | Lise Ann Caldara | Obstetrics & Gynecology | 75 Francis St, Boston, MA 02115-6110 | 2019-04-12 |
| 1851687446 | Amy J Bregar | Obstetrics & Gynecology | 55 Fruit St, Boston, MA 02114 | 2011-06-22 |
| 1316246549 | Michelle Ruth Davis | Obstetrics & Gynecology | 75 Francis St, Boston, MA 02115-6110 | 2011-03-28 |
| 1073824835 | Lily Huiling Wu | Obstetrics & Gynecology | 330 Brookline Ave, Boston, MA 02215-5400 | 2010-06-27 |
| 1760623300 | Olav Istre | Obstetrics & Gynecology | 75 Francis St, Brigham & Women's Hospital Obgyn, Boston, MA 02115-6110 | 2009-03-11 |
| 1013157734 | Michael Joe Worley Jr. | Obstetrics & Gynecology | 75 Francis St, Boston, MA 02115-6110 | 2009-02-21 |
| 1790988798 | Louise P. King | Obstetrics & Gynecology | 75 Francis St, Boston, MA 02115-6110 | 2007-06-07 |
| 1760690358 | Roger Lefevre | Obstetrics & Gynecology | 330 Brookline Ave, Boston, MA 02215-5400 | 2007-05-18 |
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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.