Jennifer Mary Joy Clark, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209023558 Issued in IL

Practice address

8308 Burlington Dr
Troy, IL 62294-4003

Phone

(618) 410-5317

NPI assigned

Sep 10, 2021

Last updated

Sep 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Inpatient Anderson Health IncGroup PAC ID 3072908474, 46 clinicians

Marshall Browning Hospital AssociationGroup PAC ID 9335049980, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anderson Hospital Hospital, Maryville, IL, CCN 140289
• Community Hospital of Staunton Hospital, Staunton, IL, CCN 141306
• Marshall Browning Hospital Hospital, Du Quoin, IL, CCN 141331
• Community Hospital of Staunton Nursing home, CCN 14Z306

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/hamilto-2525a05c
• Direct secure messaging: jclark06@yourcarecommunity.org
• Direct secure messaging: jclark524326@direct-ehr-ssmhc.com

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

• Marshall Browning Hospital Association

  • Critical Access Hospital
  • Du Quoin, IL
  • NPI 1821099441
  Medicare reassignment Care Compare group NPD
• Midwest Inpatient Anderson Health, Inc

  • Emergency Medicine Physician
  • Maryville, IL
  • NPI 1821758608
  Medicare reassignment Care Compare group NPD
• Ahs Il Medical Group LLC

  • Clinic/Center
  • Granite City, IL
  • NPI 1659098101
  Medicare reassignment NPD
• Hamilton Memorial Hospital District

  dba Hamilton Memorial Family Clinic

  • Rural Health Clinic/Center
  • McLeansboro, IL
  • NPI 1609837665
  Medicare reassignment NPD
• Midwest Emergency Anderson Health, Inc

  • Emergency Medicine Physician
  • Staunton, IL
  • NPI 1710647615
  Medicare reassignment NPD
• Trinity Medical Staffing LLC

  • Internal Medicine Physician
  • Harrisburg, IL
  • NPI 1770103426
  Medicare reassignment NPD
• Granite City Hospitalist Services LLC

  • Hospitalist Physician
  • Carbondale, IL
  • NPI 1669926424
  Medicare reassignment
• Hamilton Memorial Hospital District

  • Critical Access Hospital
  • McLeansboro, IL
  • NPI 1447257258
  NPD
• Hamilton Memorial Hospital District

  dba Carmi Family Clinic

  • Rural Health Clinic/Center
  • Carmi, IL
  • NPI 1588902183
  NPD
• Marshall Browning Hospital Association

  dba MBH East Medical Clinic

  • Rural Health Clinic/Center
  • Du Quoin, IL
  • NPI 1912490277
  NPD

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

• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation
• Community Hospital of Staunton

  • Medicare Defined Swing Bed Hospital Unit
  • Staunton, IL
  • NPI 1144240193

  Nursing home

  Care Compare affiliation
• Community Hospital of Staunton

  • Critical Access Hospital
  • Staunton, IL
  • NPI 1750308631
  Care Compare affiliation
• Marshall Browning Hospital Association

  • Critical Access Hospital
  • Du Quoin, IL
  • NPI 1821099441
  Care Compare affiliation

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1013686203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8308 BURLINGTON DR",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622944003",
            "telephone_number": "618-410-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8308 BURLINGTON DR",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622944003",
            "telephone_number": "618-410-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "middle_name": "MARY JOY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dolores M Cantrell, MD
• Brienne M Cason, SLP
• CC Smiles LLC
• Chiropro of Glened LLC Dba Chiropro of Troy
• Choices Counseling, Inc.
• Caroline Connolly, DMD
• Jill Suzanne Corder, LCSW
• Michael G Csaszar, D.M.D.
• Megan Daniele Daniels, BCBA
• Ann Davis, ANP

• Family Nurse Practitioner in Troy, IL
• Providers in Troy, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.