Active NPI
Mary Janet Clark, ARNP
- Family Nurse Practitioner
- Gainesville, FL
National Provider Identifier
1255345047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1279432
- Practice address
- 1601 SW Archer Rd
#118
Gainesville, FL 32608-1135 - Phone
- (352) 376-1611
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1279432 | FL | Primary |
Addresses
Primary practice location
1601 SW Archer Rd
#118
Gainesville, FL 32608-1135
Mailing address
2825 SE 45TH St
Ocala, FL 34480-7225
Phone (352) 867-7067
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y8814 | Other | FL | BS PROV |
Other names 1
- Mary Janet Stelzmann
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1279432 | FL | MD | Family Nurse Practitioner |
Organizations & group practices 1
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.
-
- Community Based Hospice Care Agency
- Ocala, FL
- NPI 1235189440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255345047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2825 SE 45TH ST",
"city": "OCALA",
"state": "FL",
"postal_code": "344807225",
"telephone_number": "352-867-7067",
"fax_number": "352-867-8363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 SW ARCHER RD",
"address_2": "#118",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326081135",
"telephone_number": "352-376-1611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "MARY",
"middle_name": "JANET",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "1279432",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS PROV",
"identifier": "Y8814",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "STELZMANN",
"middle_name": "JANET",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.