Active NPI
Tara Clark
- Family Nurse Practitioner
- Owensboro, KY
National Provider Identifier
1124520986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 3011436
- Practice address
- 2200 E Parrish Ave
BLDG D Suite 100
Owensboro, KY 42303 - Phone
- (270) 688-1770
- Fax
- (270) 688-1781
- NPI assigned
- Mar 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3011436 | KY | Primary |
Addresses
Primary practice location
2200 E Parrish Ave
BLDG D Suite 100
Owensboro, KY 42303
Mailing address
2200 E Parrish Ave
BLDG D Suite 100
Owensboro, KY 42303
Phone (270) 688-1770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 74.64 of 100
- Quality
- 45.57
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurosurgical Consultants LLP | Family | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520380800000",
"number": "1124520986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 E PARRISH AVE",
"address_2": "BLDG D SUITE 100",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "42303",
"telephone_number": "270-688-1770",
"fax_number": "270-688-1781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 E PARRISH AVE",
"address_2": "BLDG D SUITE 100",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "42303",
"telephone_number": "270-688-1770",
"fax_number": "270-688-1781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "TARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-07",
"last_updated": "2018-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3011436",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owensboro, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.