MRS. SHANNON JACKIE CLARK
NPI 1700940855
Contractor in Vail, AZ

Active since December 21, 2006
12729 S OX CART TRL, VAIL, AZ 85641(512) 214-2841(520) 750-0056 Get Directions Write a Review

NPPES record last updated: December 26, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Shannon Jackie Clark NPPES

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

MRS. SHANNON JACKIE CLARK (NPI 1700940855) is an individual contractor provider in Vail, Arizona, licensed in Arizona (11816) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1700940855
Entity TypeIndividualFemale
Primary Taxonomy171W00000X
Provider Legal NameMRS. SHANNON JACKIE CLARK
Location Address12729 S OX CART TRLVail, AZ 85641-9232
Mailing Address12729 S Ox Cart TrlVail, AZ 85641-9232 · (512) 214-2841 · Fax (520) 750-0056
Fax(520) 750-0056
Sole ProprietorYes
Enumeration DateDecember 21, 2006
Last NPPES UpdateDecember 26, 2024
NPPES CertifiedDecember 26, 2024
NPI 1700940855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyContractorOther Service Providers
Taxonomy Code171W00000X
License Licensed in AZ · 11816
Definition
For the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patient's environment to accommodate a health condition. Contractors perform projects including, but not limited to, building wheelchair ramps, widening doorways, modifying personal vehicles, and making other improvements for patient access and movement. This code has no relation to a provider's employment status.
12729 S OX CART TRL, Vail, AZ 85641

Other Identifiers 1

Medicaid162753AZ

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 Shannon Clark's NPI number?

The NPI number for Shannon Clark is 1700940855. It was assigned to this individual provider in the NPPES registry on December 21, 2006.

Where is Shannon Clark located?

Shannon Clark practices at 12729 S Ox Cart Trl, Vail, AZ 85641. The listed phone number is (512) 214-2841.

What is Shannon Clark's specialty?

The primary specialty registered for this NPI is Contractor with taxonomy code 171W00000X.

When was this NPI record last updated?

The NPPES record for Shannon Clark was last updated on December 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.