Dakota Ellis Clark, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-156690 Issued in AL

Practice address

380 Woods Cove Rd
Scottsboro, AL 35768-2428

Phone

(256) 218-3340

Fax

(256) 218-3655

NPI assigned

Jun 19, 2023

Last updated

Jun 19, 2023By 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 AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dakota.clark.1@29332.direct.athenahealth.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.

• Highlands Professional Services

  dba Harmony Healthcare

  • Specialist
  • Scottsboro, AL
  • NPI 1750041786
  Medicare reassignment NPD
• Scottsboro OB GYN Specialists LLC

  • Obstetrics & Gynecology Physician
  • Scottsboro, AL
  • NPI 1972658300
  NPD

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1033894043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 WOODS COVE RD",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682428",
            "telephone_number": "256-218-3340",
            "fax_number": "256-218-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 WOODS COVE RD",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682428",
            "telephone_number": "256-218-3340",
            "fax_number": "256-218-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAKOTA",
        "middle_name": "ELLIS",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-156690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theia Ann Chaffin, CCC-SLP
• Charles B. Lovelady, M.D., L.L.C.
• Charles R Bradford MD PC
• Madison Ashleigh Childress
• Chelsea Victoria Clark, MD
• Melinda Pace Clark, L.C.S.W.
• Christopher Brian Clayton, M.D.
• Whitney Claridy Clayton, CRNP
• Brandy S Clemons, PT
• Cloverdale Health Care, Inc. (Cloverdale Rehabilitation and Nursing Center)

• Family Nurse Practitioner in Scottsboro, AL
• Providers in Scottsboro, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.