Individual provider Active NPI

Brynne Elizabeth Clark, RN,BSN

  • Registered Nurse
  • Hilton, NY
National Provider Identifier
1154075646
Registry record updated Feb 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
641792 Issued in NY
Practice address
412 Burritt Rd
Hilton, NY 14468-9770
Phone
(585) 313-9593
NPI assigned
Feb 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 641792 NY Primary

Addresses

Primary practice location

412 Burritt Rd
Hilton, NY 14468-9770

Mailing address

412 Burritt Rd
Hilton, NY 14468-9770
Phone (585) 313-9593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
641792NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644105600000",
    "number": "1154075646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 BURRITT RD",
            "city": "HILTON",
            "state": "NY",
            "postal_code": "144689770",
            "telephone_number": "585-313-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 BURRITT RD",
            "city": "HILTON",
            "state": "NY",
            "postal_code": "144689770",
            "telephone_number": "585-313-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BRYNNE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "RN,BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-06",
        "certification_date": "2022-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "641792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.