Casey Daniel Clark, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN214247 Issued in GA

Practice address

230 Sheraton Blvd
Macon, GA 31210-1358

Phone

(478) 474-2947

Fax

(478) 971-8149

NPI assigned

Nov 22, 2017

Sex

Male

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 GA

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

Merit-based Incentive Payment System (MIPS)

Final score

93.47 of 100Reported as group

Quality

95.79

Promoting interoperability

96

Improvement activities

40

Cost

85.79

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Nexus Pain Center of Houston County

  • Specialist
  • Warner Robins, GA
  • NPI 1871681957
  Medicare reassignment NPD
• Nexus Pain Center of Houston County

  • Pain Medicine (Anesthesiology) Physician
  • Dublin, GA
  • NPI 1417757204
  NPD
• Axis Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Macon, GA
  • NPI 1396141545
  NPD (past)

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1225542558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 SHERATON BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101358",
            "telephone_number": "478-474-2947",
            "fax_number": "478-971-8149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 SHERATON BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101358",
            "telephone_number": "478-474-2947",
            "fax_number": "478-971-8149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CASEY",
        "middle_name": "DANIEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-22",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN214247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Enrique Chung, MD
• Gloria Smith Cisse, LPC, LMSW
• Citadel Health LLC
• Debra Clapp, PARAPROFESSIONAL, BA
• Clark General Dentistry Center, P.C.
• Edward K Clark, MD
• Ileha M Clark
• Julie J Clark, FNP-BC
• Kameron Alexander Clark, MD
• Kiofa Enez Clark, D.C.

• Nurse Practitioner in Macon, GA
• Providers in Macon, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.