Individual provider Active NPI

Eric Christopher Clark, AGACNP

  • Gerontology Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1013553494
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
30593 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-2429
Phone
(615) 322-3000
NPI assigned
Nov 21, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0000201413 TN
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X 30593 TN
Acute Care Nurse Practitioner 363LA2100X 230131 LA
Gerontology Nurse Practitioner 363LG0600X 30593 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-2429

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691

Other practice location 1

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-5638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, LA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211230001127 TN Practitioner - Nurse Practitioner 3678964673 Reassigns benefits to 1 organization
I20230809002435 LA Practitioner - Nurse Practitioner 3678964673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Practice addresses (Care Compare)

1301 Medical Ctr Dr
Nashville, TN 37232-0028
Phone (615) 322-5000

Hospital & facility affiliations

  • Vanderbilt University Medical Center Hospital, Nashville, TN, CCN 440039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0000201413TNMDRegistered Nurse
230131LAMDAcute Care Nurse Practitioner
30593TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Multi-Specialty Current Accepting new patients
Ochsner Clinic LLC Multi-Specialty CurrentSince Jul 24, 2023 Accepting new patients
Ochsner Clinic LLC Multi-Specialty CurrentSince Jul 24, 2023 Accepting new patients
Vanderbilt University Medical Center Multi-Specialty CurrentSince Jan 25, 2025 Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

1514 Jefferson Hwy
New Orleans, LA 70121

1301 Medical Center Dr
Nashville, TN 37232
Phone (615) 343-4882

1211 Medical Center Dr
Nashville, TN 37232
Phone (615) 322-0160

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

Interoperability endpoints

  • Direct secure messaging: eclark20407@direct.vumc.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1013553494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372322429",
            "telephone_number": "615-322-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 Jefferson Hwy",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701212429",
            "country_code": "US",
            "telephone_number": "504-842-5638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ERIC",
        "middle_name": "CHRISTOPHER",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-21",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "0000201413",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "30593",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "230131",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "30593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.