Lee Ann Clark

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

326 W 11TH St
Shawnee, OK 74801-6710

Phone

(918) 696-1545

NPI assigned

Jan 25, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1215491048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 N BEARD AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748016105",
            "telephone_number": "918-696-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 W 11TH ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748016710",
            "telephone_number": "918-696-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LEE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-25",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Citizen Potawatomi Nation (Citizen Potawatomi Nation West Clinic)
• Citizen Potawatomi Nation Mail Order Pharmacy (CPN Mail Order Pharmacy)
• Citizen Potawatomi Nation West Clinic
• Gregory Ray Clark, P.T.
• Julianne Alyssa Clark, ARNP
• Lou Clark
• Rachel Louise Clark
• Tanner Clark, M.S.
• Stacey Clary, BHA
• Norma Cleere, LPN

• Case Manager/Care Coordinator in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; 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.