Individual provider Active NPI

Clarissa Jane Tomlin

  • Family Nurse Practitioner
  • Enterprise, AL
National Provider Identifier
1205425873
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-148343 Issued in AL
Practice address
6582 Boll Weevil Cir
Enterprise, AL 36330-9424
Phone
(334) 347-2027
NPI assigned
Jan 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-148343 AL Primary

Addresses

Primary practice location

6582 Boll Weevil Cir
Enterprise, AL 36330-9424

Mailing address

6582 Boll Weevil Cir
Enterprise, AL 36330-9424
Phone (334) 347-2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210303000468 AL Practitioner - Nurse Practitioner 4385059294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flowers HB Medical Services LLCGroup PAC ID 6305290990, 139 clinicians

Practice addresses (Care Compare)

4370 W Main St
Dothan, AL 36305-1056
Phone (334) 793-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
45.86 of 100Reported as group
Quality
6.09
Improvement activities
40
Cost
81.25

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Enterprise Urgent Care CurrentSince Jan 4, 2021 Accepting new patients
Flowers HB Medical Services LLC CurrentSince Oct 8, 2023 Accepting new patients
Ivycreek of Elmore LLC PastSince Jan 4, 2021 Accepting new patients

Locations

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

6582 Boll Weevil Cir
Enterprise, AL 36330
Phone (334) 347-2027

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1205425873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6582 BOLL WEEVIL CIR",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363309424",
            "telephone_number": "334-347-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6582 BOLL WEEVIL CIR",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363309424",
            "telephone_number": "334-347-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLIN",
        "first_name": "CLARISSA",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-148343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.