Anissa Brant Clark, RN

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

0001226621 Issued in VA

Practice address

929 Estates Rd SE
Roanoke, VA 24014-4307

Phone

(540) 676-4806

NPI assigned

Mar 4, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1114674645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 ESTATES RD SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240144307",
            "telephone_number": "540-676-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 ESTATES RD SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240144307",
            "telephone_number": "540-676-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANISSA",
        "middle_name": "BRANT",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-04",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "VA",
            "license": "0001226621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Rosevear Cladis, M.D.
• Kathleen Clancy, DO, MPH
• Teresa Clapp, COTA/L
• Clarity Counseling and Assessment
• Clarity Counseling and Consulting
• Carolyn Clark, M.D.
• Christopher M Clark, LICENSED OPTICIAN
• Eric Clark, LCSW
• Jeffrey Dean Clark, D.D.S.
• Lynn Robinson Clark, DDS

• Case Management Registered Nurse in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Case Management Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.