Timiera Clark, OWNER

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

License

019428 Issued in TX

Practice address

5601 Bridge St Ste 300
Fort Worth, TX 76112-2355

Phone

(817) 902-8085

NPI assigned

Aug 8, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Timiera Clark Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Bountiful Community Home Health L.L.C.

  • In Home Supportive Care Agency
  • Fort Worth, TX
  • NPI 1316471436
  NPD Authorized official

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1093360802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 BRIDGE ST STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761122355",
            "telephone_number": "817-902-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 BRIDGE ST STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761122355",
            "telephone_number": "817-902-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TIMIERA",
        "credential": "OWNER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "TX",
            "license": "019428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIMIERA",
            "last_name": "CLARK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lisamarie Helen Clark, OD
• Megan H Clark, S.L.P.
• Sandra Clark, LPC ASSOCIATE
• Sharon Ellen Clark, DO MPH
• Susan Clark, LCSW-S
• Howard F Clarke Jr., PA
• Khalilah Q Clarke, MD
• Tyler A Clarke, LPC
• Sandra Lynne Clarkson, M.A., CCC-A, FAAA
• Ashley M Classen, D.O.

• Attendant Care Provider in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Attendant Care Provider in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.