Mara M Clarke, NPC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Practice address

515 Valley View Dr
Suite 103
Moline, IL 61265-6175

Phone

(309) 757-1252

NPI assigned

Oct 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• McLoone Family Practice PC

  • Family Medicine Physician
  • Moline, IL
  • NPI 1699963223
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174619480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 VALLEY VIEW DR",
            "address_2": "SUITE 103",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656175",
            "telephone_number": "309-757-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 VALLEY VIEW DR",
            "address_2": "SUITE 103",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656175",
            "telephone_number": "309-757-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "MARA",
        "middle_name": "M",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Circello
• City of Moline
• Charmaine Clark
• Jason Craig Clark, M.D.
• Rebekah Ann Clark, LPHA,LCSW
• Diann M Clem, DPT
• Ann Katherine Cobb, CCC/SLP
• Robert Cobert, APN
• Marcella Ann Cochran, CNA
• Mary Cockrell, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.