Marco Clark, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT.0001708 Issued in CO

Practice address

2032 9TH Ave
Greeley, CO 80631-1614

Phone

(970) 402-2746

NPI assigned

Dec 3, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1480723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1972046308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 9TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806311614",
            "telephone_number": "970-402-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 9TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806311614",
            "telephone_number": "970-402-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARCO",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-03",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CO",
            "license": "AT.0001708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Sue Clang, DO
• Jayme L Clapp, MS, LPC
• Amanda Mae Clark
• Evelyn Bardago Clark, MSN, ANP, NP-C
• Lenaise Clark, M.S
• Paula Fae Clark, FNP
• William Dale Clark, PHARMD
• Scott D Clawson, CAC III
• Kevin Michael Clay, M.D.
• Chris Clayton

• Athletic Trainer in Greeley, CO
• Providers in Greeley, CO by specialty
• Athletic Trainer in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2017; 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.