Whitney Clark, AGPCNP-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP143273 Issued in TX

Practice address

319 Gaslight Blvd
Lufkin, TX 75904-3124

Phone

(936) 634-3713

NPI assigned

Oct 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

• FHIR API: https://fhir4.healow.com/fhir/r4/IFEIBA

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.

• Malladi & Reddy, PA

  • Gastroenterology Physician
  • Lufkin, TX
  • NPI 1508986373
  Medicare reassignment NPD
• Warner Health Associates, Inc.

  • Family Nurse Practitioner
  • Lufkin, TX
  • NPI 1467046896
  Medicare reassignment NPD
• East Texas Primary Care Physicians, PLLC

  • Family Medicine Physician
  • Longview, TX
  • NPI 1447308903
  NPD (past)

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1043851645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 GUY YORK RD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759011777",
            "telephone_number": "936-581-6029",
            "fax_number": "936-634-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043124",
            "telephone_number": "936-634-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WHITNEY",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP143273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "whitney.clark@wma.eclinicaldirectplus.com",
            "affiliation": "Y",
            "endpointDescription": "direct messaging",
            "affiliationName": "Malladi & Reddy, PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "319 Gaslight Blvd",
            "city": "Lufkin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "759043124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• City of Lufkin
• Clark Psychological & Consultation PC
• Frankie Jo Clark, M.ED., PH.D.
• Sapphira Jo Clark, NP
• Tara Clark, MS, CF-SLP
• Clifton H. Cathcart, D.O., P.a.
• CNC Care Homes LLC
• Shalyn Danielle Denise Cofer
• Media M Cole, CHW
• Megan Shea Cole

• Gerontology Nurse Practitioner in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.