Pontris Sapp Clark, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

A1007111 Issued in TX

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(800) 561-0861

NPI assigned

Nov 5, 2007

Last updated

Sep 16, 2020By 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 2

Addresses

Other names 1

• Pontress Denise Clark Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• North Texas Nephrology Associates PA

  • Nephrology Physician
  • Arlington, TX
  • NPI 1629107404
  NPD (past)

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1215117593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 TORREY PINES DR",
            "city": "N RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761800832",
            "telephone_number": "817-676-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "800-561-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "PONTRIS",
        "middle_name": "SAPP",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "465762",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "A1007111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PONTRESS",
            "last_name": "CLARK",
            "middle_name": "DENISE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Citadel South Woods LLC
• Citadel Southwest Commons LLC
• Angela M Clapp, FNP-BC
• Diane Maxine Clark, PT
• Kaulette Clark
• Steven Allen Clark, MD
• Jazmin Clausen-Thomas
• Kendall Marie Clausen
• Monica Clayton
• Darla Cleary, MA, LPCC

• Adult Health Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.