Jaclyn Clark, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

SP030814 Issued in PA

Practice address

600 E Market St Ste 303
West Chester, PA 19382-2748

Phone

(610) 738-2690

NPI assigned

Oct 15, 2024

Last updated

Oct 16, 2024By 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 PA

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

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.

• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342
  Medicare reassignment NPD
• University of Penn - Medical Group

  • Allergy & Immunology Physician
  • Philadelphia, PA
  • NPI 1659488351
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1033939962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 WAID WAY",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012215",
            "telephone_number": "215-582-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E MARKET ST STE 303",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193822748",
            "telephone_number": "610-738-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JACLYN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP030814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey J Citara, DO
• Peter Clain, MPT
• Carol E Clapham, LCSW
• Davis Whitney Clark Jr., DO
• Emma Clark
• Taylor E Clark, CRNP
• Leanne Clarke
• Mary Beth Clarke, CRNA
• Ronald P Clauhs, M.D.
• Kelsey Clawson

• Acute Care Nurse Practitioner in West Chester, PA
• Providers in West Chester, PA by specialty
• Acute Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.