Christina Jane Clark, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4747 Issued in OK

Practice address

5201 W Memorial Rd
Oklahoma City, OK 73142-2004

Phone

(405) 755-4050

NPI assigned

Nov 5, 2021

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 OK

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

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Mercy Hospital Logan County, IncGroup PAC ID 4587836200, shared by 4 NPIs, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Home Health Home health agency, Oklahoma City, OK, CCN 377048
• Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
• Mercy Hospital Logan County Hospital, Guthrie, OK, CCN 371317

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment Care Compare group

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

• Mercy Hospital Logan County Inc

  • Critical Access Hospital
  • Guthrie, OK
  • NPI 1306126818
  Care Compare affiliation
• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  Care Compare affiliation
• Mercy Hospital Oklahoma City, Inc.

  • Home Health Agency
  • Oklahoma City, OK
  • NPI 1437256070
  Care Compare affiliation

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1093470957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W OAKLAND ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740121656",
            "telephone_number": "918-251-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422004",
            "telephone_number": "405-755-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 W Oakland St",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740121656",
            "country_code": "US",
            "telephone_number": "918-251-2666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTINA",
        "middle_name": "JANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-05",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Jo Clark, PRSS
• Brandi Nicole Clark
• Brian E Clark
• Caitlyn Grace Clark, PHARMD
• Carrie Jean Clark, D.O
• Debra Bynum Clark, ARNP
• Dori Clark, M.S. CCC-SLP
• Elizabeth Lynne Clark
• Emilyanne Clark
• Gayle Clark, LCSW

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.