Active NPI
Teri Lynn Clark, ONCOLOGY ESTHETICIAN
- Specialist
- Ocala, FL
National Provider Identifier
1013215334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- FB9716027
- Practice address
- 2530 SW 27TH Ave
Ocala, FL 34471-4390 - Phone
- (352) 237-6096
- Fax
- (352) 236-6099
- NPI assigned
- Mar 10, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | FB9716027 | FL | Primary |
Addresses
Primary practice location
2530 SW 27TH Ave
Ocala, FL 34471-4390
Mailing address
2530 SW 27TH Ave
Ocala, FL 34471-4390
Phone (352) 237-6096
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FB9716027 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299715200000",
"number": "1013215334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2530 SW 27TH AVE",
"city": "OCALA",
"state": "FL",
"postal_code": "344714390",
"telephone_number": "352-237-6096",
"fax_number": "352-236-6099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2530 SW 27TH AVE",
"city": "OCALA",
"state": "FL",
"postal_code": "344714390",
"telephone_number": "352-237-6096",
"fax_number": "352-236-6099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "TERI",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "ONCOLOGY ESTHETICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-10",
"last_updated": "2011-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "FB9716027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocala, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.