Meredith Clark, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL1607 Issued in FL

Practice address

41 Fairpoint Dr Ste B
Gulf Breeze, FL 32561-4380

Phone

(850) 916-9777

NPI assigned

Jul 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316962715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 SHARKHEAD CIR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 FAIRPOINT DR STE B",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614380",
            "telephone_number": "850-916-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MEREDITH",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL1607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Ray Chandler, MD
• Child Neurology Center of Northwest Florida PA
• Child Neurology Center of NW FL PA
• CHP Gulf Breeze FL Tenant Corp (The Beacon at Gulf Breeze)
• Karlee Clark, APRN
• Ronald Harris Clayton
• Renea Kathleen Clowdsley, APRN
• Club2,LLC
• Coastal Kids Endocrinology and Weight Management LLC
• Coastal Medical Integration Inc

• Athletic Trainer in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.