Elisabeth Danielle Clark

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

S13072 Issued in AL

Practice address

106A Saraland Loop
Saraland, AL 36571-2419

Phone

(251) 675-3333

NPI assigned

Jan 14, 2021

Last updated

Jan 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1982293874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11551 KALI OKA RD",
            "city": "EIGHT MILE",
            "state": "AL",
            "postal_code": "366138729",
            "telephone_number": "334-360-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106A SARALAND LOOP",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365712419",
            "telephone_number": "251-675-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELISABETH",
        "middle_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": "S13072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ray E Case, DC
• Lorenzo Catlett, PT, DPT
• Nancy Champion, CRNP
• Melanie Anne Chorvat, PA
• CK Family Dental, LLC (CK Family Dental)
• Joshua Dane Clarke, CRNP
• Coastal Hospice Care, Inc. (Coastal Hospice)
• Coastal River Wellness of Alabama
• Cole Vision Corporation
• Comfort Dental of Saraland

• Student in an Organized Health Care Education/Training Program in Saraland, AL
• Providers in Saraland, AL by specialty
• Student in an Organized Health Care Education/Training Program in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.