Individual provider Active NPI

Carlene M McClurg, NP

  • Nurse Practitioner
  • Angola, IN
National Provider Identifier
1235164732
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71000700A Issued in IN
Practice address
301 E Maumee St
Angola, IN 46703-2012
Phone
(260) 667-5635
Fax
(260) 665-8852
NPI assigned
Jul 12, 2006
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71000700A IN Primary
Family Nurse Practitioner 363LF0000X 71000700A IN

Addresses

Primary practice location

301 E Maumee St
Angola, IN 46703-2012

Mailing address

416 E Maumee St
Angola, IN 46703-2015
Phone (260) 667-5131

Other identifiers 1

IdentifierTypeStateIssuer
000000490402OtherINANTHEM BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050328000424 IN Practitioner - Nurse Practitioner 0042266678 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cameron Memorial Community Hospital IncGroup PAC ID 9234020835, shared by 8 NPIs, 83 clinicians

Practice addresses (Care Compare)

301 E Maumee St
Angola, IN 46703-2012
Phone (260) 675-7535

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cameron Memorial Community Hospital, Inc. CurrentSince Jan 18, 2024 Accepting new patients
Cameron Memorial Community Hospital, Inc Family CurrentSince Jan 18, 2024 Accepting new patients
Fawver Waldo Clinic LLP Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

301 E Maumee St
Angola, IN 46703
Phone (260) 665-2164

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

Interoperability endpoints

  • Direct secure messaging: cmcclurg11990@direct.parkviewexchange.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1235164732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032015",
            "telephone_number": "260-667-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032012",
            "telephone_number": "260-667-5635",
            "fax_number": "260-665-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURG",
        "first_name": "CARLENE",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000700A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000700A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000490402",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.