Donna Patricia Clark, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0017141207 Issued in VA

Practice address

12388 Warwick Blvd Ste 302
Newport News, VA 23606-3858

Phone

(757) 679-6058

Fax

(757) 926-5465

NPI assigned

Mar 7, 2014

Last updated

Oct 4, 2017By 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

Other names 1

• Dr. Donna Patricia Clark Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• DPC Jewett LLC

  dba Dominion Patient Care Services

  • Health Maintenance Organization
  • Newport News, VA
  • NPI 1366975633
  Authorized official Same address or phone
• Available Mental Health Services, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Newport News, VA
  • NPI 1558722694
  NPD (past)
• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  NPD (past)

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1215353743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EMANCIPATION DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236670001",
            "telephone_number": "757-722-9961",
            "fax_number": "757-728-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12388 WARWICK BLVD STE 302",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063858",
            "telephone_number": "757-679-6058",
            "fax_number": "757-926-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DONNA",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0017141207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "CLARK",
            "middle_name": "PATRICIA",
            "prefix": "DR.",
            "credential": "DNP, FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• CK Professional Group
• Tanya L Claiborne, PHARM.D.
• Cariana Josephine Clanton, DO
• Anna Irene Clark, MD
• Dana Maria Clark, PA-C
• Matthew Mitchell Clark, DMD
• NA'Zae Athena Clark, PA-C
• Sarah Clark, MOT
• Theresa Hitselberger Clark, MD
• Thomas W Clark, M.S., M.D., F.A.C.S.

• Family Nurse Practitioner in Newport News, VA
• Providers in Newport News, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.