NPIMap

Individual provider Active NPI

Aylah Clark, N.D.

  • Naturopath
  • Avon, CT
National Provider Identifier
1013393487
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
5.000540 Issued in CT
Practice address
100 Simsbury Rd
209
Avon, CT 06001-3793
Phone
(860) 674-0111
NPI assigned
Aug 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 5.000540 CT Primary

Addresses

Primary practice location

100 Simsbury Rd
209
Avon, CT 06001-3793

Mailing address

100 Simsbury Rd
209
Avon, CT 06001-3793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5.000540CTMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Mark S Stagg DC LLC PastSince Oct 30, 2022 Accepting new patients
Jennifer J Stagg ND LLC Naturopath PastSince Oct 30, 2022 Accepting new patients
Third Stone Integrative Health Center Naturopath Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1013393487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SIMSBURY RD",
            "address_2": "209",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SIMSBURY RD",
            "address_2": "209",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013793",
            "telephone_number": "860-674-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "AYLAH",
        "credential": "N.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CT",
            "license": "5.000540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.