Tucker Clark

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-23-287185 Issued in HI

Practice address

6910 Silverheel St
Shawnee, KS 66226-5316

Phone

(913) 405-4550

NPI assigned

Aug 23, 2023

Last updated

Jul 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bluehawk Creative Learning Center, Inc.

  • Behavior Analyst
  • Shawnee, KS
  • NPI 1609589324
  NPD
• Behavior Analysis No Ka Oi Inc

  • Behavior Analyst
  • Honolulu, HI
  • NPI 1811368574
  NPD (past)
• Behavior Analysis No Ka Oi Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Honolulu, HI
  • NPI 1356502066
  NPD (past)

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1184408742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 N PERSIMMON DR",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660615965",
            "telephone_number": "785-764-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 SILVERHEEL ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662265316",
            "telephone_number": "913-405-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TUCKER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-23",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": "RBT-23-287185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Denise Clanton, PTA
• Gordon Blake Clark, MD
• Matthew Corbin Clark, LMSW
• Tina M Clark, LSCSW
• Tracy A Clark, ARNP
• Barbara Gaye Cleverdon, LCMFT
• Clifford L. Holt, O.D.
• Clifford L. Holt, O.D.,P.a.
• Perry L Cobb, RPH
• Karinne Coberly

• Behavior Technician in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Behavior Technician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.