Tanisha Tiana Clark
NPI 1871095935ActiveIndividual· Specialist/Technologist, Athletic Trainer· Wallingford, CT
Specialist/Technologist, Athletic Trainer in Wallingford, Connecticut, licensed in CT, with an NPI issued in March 2018.
Overview
| NPI | 1871095935 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Mar 5, 2018 |
| Last updated in NPPES | Feb 15, 2021 |
| Certified by provider | Feb 15, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist/Technologist, Athletic Trainer Primary | 2255A2300X | 54.001470 | CT |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
| Specialist/Technologist, Athletic Trainer | 2255A2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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