Kristina Clark, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN9324590 Issued in FL

Practice address

1420 SW Saint Lucie West Blvd Ste 107
Port Saint Lucie, FL 34986-1709

Phone

(772) 879-1112

Fax

(772) 879-1167

NPI assigned

Feb 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Richard J Pena- Ariet MD PAGroup PAC ID 4183705445, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

Medicare enrollment (NPD)

Enrolled

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.

• Richard J Pena- Ariet MD PA

  • Internal Medicine Physician
  • Port Saint Lucie, FL
  • NPI 1609804624
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Martin Memorial Medical Center Inc

  dba Cleveland Clinic Martin North, South, Tradition Hospitals

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055
  Care Compare affiliation

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1063871341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9886 E. VERONA CIRCLE",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329666670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 SW SAINT LUCIE WEST BLVD STE 107",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861709",
            "telephone_number": "772-879-1112",
            "fax_number": "772-879-1167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9035 Americana Rd Ste 13",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329666670",
            "country_code": "US",
            "telephone_number": "954-531-8630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9886 E Verona Cir",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329663119",
            "country_code": "US",
            "telephone_number": "954-531-8630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KRISTINA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9324590",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9324590",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9324590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ciufo
• Yolie Cius
• CJM Counseling and Wellness, LLC
• Chapelle Clark
• Ganiece Clark, PHLEBOTOMIST
• Charmaine Tania Clarke, CASE MANAGER
• Edwin Russelle Clarke, RPH
• Ian Clarke, PHARM.D.
• Desirae E Classen
• Clearpath Health LLC

• Family Nurse Practitioner in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.