Colleen Clarke, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

335906 Issued in NY

Practice address

4930 Darien Dr
Liverpool, NY 13088-5802

Phone

(585) 491-0056

NPI assigned

Jan 2, 2025

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

Other names 1

• Colleen Kennedy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1093524274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 DARIEN DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130885802",
            "telephone_number": "585-491-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 DARIEN DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130885802",
            "telephone_number": "585-491-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "COLLEEN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "335906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "KENNEDY",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cinemedics Cny LLC
• Aaron D Clark, PT
• Robert Frederick Clark, DDS
• Shannen Clark, COUNSELOR
• Stacy Clark
• Mary Claytor
• Kimberly Cleary, RN
• Alexis Clement
• Alicia E Clifford, LCSW-R
• Lauren Anne Clonan

• Licensed Practical Nurse in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.