Madeline Rae Clarke, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95198067 Issued in CA

Practice address

1260 Morena Blvd Ste 100
San Diego, CA 92110-3850

Phone

(619) 398-0355

NPI assigned

Jul 27, 2021

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

• Madeline Rae Avery Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1255004131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 GLENWOOD CIR APT 27H",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939406732",
            "telephone_number": "515-537-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 MORENA BLVD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103850",
            "telephone_number": "619-398-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "MADELINE",
        "middle_name": "RAE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95198067",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95198067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELINE",
            "last_name": "AVERY",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Debbie A Clarke
• Derly Clarke, RD, CDE
• Hannah Clarke
• Keith Andrew Clarke, CPT, CMT
• Keysha Clarke
• Mary K Clarke, NP
• Megan Eileen Clarke, DDS
• Anne Elizabeth Clarkin, L.C.S.W.
• Hakiem Clarkson
• Audi Claros

• Registered Nurse in San Diego, CA
• Providers in San Diego, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.