Kristen Nancy Feifert Clark, MSN CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

RN242199 Issued in MA

Practice address

22 West St Ste 25
Millbury, MA 01527-2622

Phone

(508) 917-6720

Fax

(508) 917-6721

NPI assigned

Nov 5, 2013

Last updated

Oct 6, 2016By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Master of Science - Nursing

State licenses

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.

• New England Reproductive Medicine and Surgery LLC

  • Reproductive Endocrinology Physician
  • Millbury, MA
  • NPI 1700215670
  NPD

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1063841534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 WEST ST STE 25",
            "city": "MILLBURY",
            "state": "MA",
            "postal_code": "015272622",
            "telephone_number": "508-917-6720",
            "fax_number": "508-917-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 WEST ST STE 25",
            "city": "MILLBURY",
            "state": "MA",
            "postal_code": "015272622",
            "telephone_number": "508-917-6720",
            "fax_number": "508-917-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEIFERT CLARK",
        "first_name": "KRISTEN",
        "middle_name": "NANCY",
        "credential": "MSN CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN242199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PTAN",
            "identifier": "110099291A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "S100140020",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Empire Vision Center, Inc. (Visionworks)
• Empowered Health Care Services (Empowered Health Care Services, LLC)
• Meryl Estabrook
• Evolve Recovery Center at Millbury LLC
• Evolve Recovery Center at Millbury Ma, LLC
• Robert K Ferguson, M.D.
• Daniel J Finn, RPH
• Lauren Fournier, M.A. BCBA
• Breanna Shannon Gagliardi
• Cynthia Ann Gaines, CADC, LADC-II

• Advanced Practice Midwife in Millbury, MA
• Providers in Millbury, MA by specialty
• Advanced Practice Midwife in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.