ALISHA VICTORIA CLARK
NPI 1205502655
Military Health Care Provider - Independent Duty Medical Technicians in Tallahassee, FL

Active since August 17, 2021
2507 OLD SAINT AUGUSTINE RD, TALLAHASSEE, FL 32301(866) 466-2475 Get Directions Write a Review

NPPES record last updated: August 17, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Alisha Victoria Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALISHA VICTORIA CLARK (NPI 1205502655) is an individual independent duty medical technicians provider in Tallahassee, Florida, licensed in Texas (E2027750) and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1205502655
Entity TypeIndividualFemale
Primary Taxonomy1710I1003X
Provider Legal NameALISHA VICTORIA CLARK
Location Address2507 OLD SAINT AUGUSTINE RDTallahassee, FL 32301-6209
Mailing Address2507 Old Saint Augustine RdTallahassee, FL 32301-6209 · (866) 466-2475
Sole ProprietorNo
Enumeration DateAugust 17, 2021
NPPES CertifiedAugust 17, 2021
NPI 1205502655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code1710I1003X
License Licensed in TX · E2027750
Definition
An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
2507 OLD SAINT AUGUSTINE RD, Tallahassee, FL 32301

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Assisted Living Facility
2507 OLD SAINT AUGUSTINE RD
TALLAHASSEE, FL 32301

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alisha Clark's NPI number?

The NPI number for Alisha Clark is 1205502655. It was assigned to this individual provider in the NPPES registry on August 17, 2021.

Where is Alisha Clark located?

Alisha Clark practices at 2507 Old Saint Augustine Rd, Tallahassee, FL 32301. The listed phone number is (866) 466-2475.

What is Alisha Clark's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Medical Technicians, with taxonomy code 1710I1003X.

When was this NPI record last updated?

The NPPES record for Alisha Clark was last updated on August 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.