Chelsea Clark

Primary specialty

Private VehicleTaxonomy code 347C00000X

License

SD785971 Issued in OH

Practice address

11439 Gresham PL
Cincinnati, OH 45240-2423

Phone

(513) 550-5394

NPI assigned

Jan 9, 2025

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

Practice roles

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.

• The Stem Lab

  • Adult Day Care Clinic/Center
  • Cincinnati, OH
  • NPI 1790595031
  NPD Authorized official

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1821808163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11439 GRESHAM PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452402423",
            "telephone_number": "513-550-5394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11439 GRESHAM PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452402423",
            "telephone_number": "513-550-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHELSEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OH",
            "license": "SD789571",
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "OH",
            "license": "SD785971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Clark, PHARM.D.
• Braydon Kyle Clark
• Carissa Clark, LSW
• Carol L Clark
• Charles Clark Jr.
• Cheyenne M Clark
• Clarence Clark Jr., NURSES AID
• Cory Douglas Clark, PA
• Daniel James Clark, M.D., PHD
• Danielle L. Clark, M.D.

• Private Vehicle in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Private Vehicle in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.