Crystal A Clark, CMA

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

331 Jamestown CT
Columbus, OH 43228-4030

Phone

(601) 480-3968

NPI assigned

Mar 8, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Medical Assistant

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1639443658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2892",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432162892",
            "telephone_number": "601-480-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 JAMESTOWN CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432284030",
            "telephone_number": "601-480-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CRYSTAL",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "CMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad David Clark, MPAS, PA-C
• Charjan Clark
• Christopher Michael Clark, D.D.S.
• Colleen Ann Clark, PHARMD
• Courtney Clark, BSN, RN, IBCLC
• Cullen J Clark
• Danielle Clark, LPCC
• Deion J Clark
• Dejon Clark
• Denise Marie Clark, OTR/L

• Personal Care Attendant in Columbus, OH
• Providers in Columbus, OH by specialty
• Personal Care Attendant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.