Clarissa Jordan Annan, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-164543 Issued in AL

Practice address

156 E 15TH Ave
Gulf Shores, AL 36542-3516

Phone

(251) 948-4290

Fax

(251) 948-7682

NPI assigned

Jun 15, 2022

Last updated

Jun 15, 2022By 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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clarissa.annan.1@4349.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/4349/brand/1/csg/1/fhir/r4

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.

• Eastern Shore Urgent Care LLC

  • Family Medicine Physician
  • Daphne, AL
  • NPI 1376706275
  Medicare reassignment NPD
• Jeanne M Birkenhauer, M.D., P.C.

  • Family Medicine Physician
  • Gulf Shores, AL
  • NPI 1841375417
  NPD (past)
• Eastern Shore Urgent Care LLC

  • Urgent Care Clinic/Center
  • Chestertown, MD
  • NPI 1548924988

  Family

  NPD (past)

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1043940687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 LAVENDER LN",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365359565",
            "telephone_number": "251-747-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 E 15TH AVE",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365423516",
            "telephone_number": "251-948-4290",
            "fax_number": "251-948-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNAN",
        "first_name": "CLARISSA",
        "middle_name": "JORDAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-164543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Aesthetics Dental Center and Spa
• Alabama CVS Pharmacy LLC (CVS Pharmacy #17236)
• Alabama Providence Healthcare Services (Providence Medical Group - Gulf Shores)
• Shelly Lee Alexander, M.S., OT/L
• Angel R Vasquez DMD PA (Serenity Dental Studio)
• Nadia Arnold
• Dacy Reynolds Atchison, PHARM.D.
• Attune Therapeutic Services
• Rebecca Lee Branum Autrey, PNP
• Savannah Axt

• Family Nurse Practitioner in Gulf Shores, AL
• Providers in Gulf Shores, 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 15, 2022; 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.