Ashley Nicole Clark, PREVENTION SPECIALIS

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

License

NOTCERTIFIED Issued in KY

Practice address

1212 Bath Ave FL 8
Ashland, KY 41101-2696

Phone

(606) 329-8588

NPI assigned

Oct 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1740756014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411050790",
            "telephone_number": "606-329-8588",
            "fax_number": "606-329-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 BATH AVE FL 8",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012696",
            "telephone_number": "606-329-8588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Private Road 977",
            "address_purpose": "LOCATION",
            "city": "Pedro",
            "state": "OH",
            "postal_code": "456598608",
            "country_code": "US",
            "telephone_number": "740-534-1386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "credential": "PREVENTION SPECIALIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "KY",
            "license": "NOTCERTIFIED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christing Jordan Webb DMD PSC
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• CJ Critical Care Transportation Systems of Ky
• Hannah Claar Bragg, PHARMD
• Claire-Frances Health Services
• Emily Clark
• Mary Clark
• Sarah Lynn Clark, COTA/L
• Tara L Clark
• Adrienne Clarke, CM

• Prevention Professional in Ashland, KY
• Providers in Ashland, KY by specialty
• Prevention Professional in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; 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.