Shonda T Clark, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209011572 Issued in IL

Practice address

5841 S Maryland Ave
Chicago, IL 60637-1447

Phone

(773) 702-3844

NPI assigned

Jun 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Texas Stroke Center, PLLCGroup PAC ID 6709927528, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Plano Hospital, Plano, TX, CCN 450651

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shonda.clark@hca7.eclinicaldirectplus.com
• Direct secure messaging: sclarkapn15728@uchospital.direct-ci.com

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.

• North Texas Stroke Center, PLLC

  • Neurology Physician
  • Plano, TX
  • NPI 1851624027
  Medicare reassignment Care Compare group NPD

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

• Columbia Medical Center of Plano Subsidiary LP

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1699726406
  Care Compare affiliation

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1114308251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 COIT RD STE 104",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756171",
            "telephone_number": "972-566-5411",
            "fax_number": "972-519-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-3844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Coit Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750756171",
            "country_code": "US",
            "telephone_number": "972-566-5411",
            "fax_number": "972-519-8337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHONDA",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1018533",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209011572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Clark, LCSW
• Sarah Beth Clark, DNP, FNP-BC
• Sean Clark, RD
• Shammona Clark, FNP-C
• Sharon Clark
• Shoshana Leonie Clark
• Stacy Clark, PH.D.
• Stephanie Clark, LCPC
• Stephanie Borjas Clark, PHD
• Susan Leighton Clark, LCSW

• Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.