Individual provider Active NPI

Rhonda K Clark, NP

  • Nurse Practitioner
  • Bassett, VA
National Provider Identifier
1154379451
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024166037 Issued in VA
Practice address
324 T B Stanley Hwy
Bassett, VA 24055-6108
Phone
(276) 629-1076
NPI assigned
May 5, 2006
Last updated
Jul 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024166037 VA Primary

Addresses

Primary practice location

324 T B Stanley Hwy
Bassett, VA 24055-6108

Mailing address

324 T B Stanley Hwy
Bassett, VA 24055-6108
Phone (276) 629-1076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20080822000327 VA Practitioner - Nurse Practitioner 6103991385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Total HealthcareGroup PAC ID 5193144368, 2 clinicians
Oandw EnterprisesGroup PAC ID 6608927298, 216 clinicians

Practice addresses (Care Compare)

2202 Daniels Creek Rd
Collinsville, VA 24078-1370
Phone (276) 647-5133

935 Fairystone Park Hwy
Stanleytown, VA 24168-3014
Phone (888) 724-0268

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024166037VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Healthcare CurrentSince Oct 1, 2020 Accepting new patients
Dr Thomas E Unterbrink OD PC PastSince Oct 2, 2020 Accepting new patients

Locations

2202 Daniels Creek Rd
Collinsville, VA 24078
Phone (276) 358-0055

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJFEDD/Endpoint/EJFEDD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1154379451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 T B STANLEY HWY",
            "city": "BASSETT",
            "state": "VA",
            "postal_code": "240556108",
            "telephone_number": "276-629-1076",
            "fax_number": "276-629-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 T B STANLEY HWY",
            "city": "BASSETT",
            "state": "VA",
            "postal_code": "240556108",
            "telephone_number": "276-629-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RHONDA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024166037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bassett, VA

Sources for this page

Verify at the official NPI Registry.