Rachel Zipporah Clark, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R165710 Issued in MD

Practice address

505 E Main St
Salisbury, MD 21804-5020

Phone

(410) 341-3420

Fax

(410) 341-3397

NPI assigned

Apr 23, 2015

Last updated

Mar 4, 2024By the provider in NPPES

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 identifiers 1

Other names 1

• Ms. Rachel Birckhead Former name

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians

HealthportGroup PAC ID 2365469947, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rachel.clark.1@8042.direct.athenahealth.com

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.

• Healthport

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Salisbury, MD
  • NPI 1154320646
  Medicare reassignment Care Compare group NPD
• Privia Care Center LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1164874426

  MD

  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, Psychiatric/Mental Health

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC, MD

  Medicare reassignment NPD
• Healthport

  • Community/Behavioral Health Agency
  • Cambridge, MD
  • NPI 1417424466
  NPD
• Healthport

  • Primary Care Clinic/Center
  • Princess Anne, MD
  • NPI 1487452934
  NPD
• Menocal Medical Services PA

  • Family Medicine Physician
  • Frederick, MD
  • NPI 1083795918
  NPD
• Privia Care Center LLC

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1730664012
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Medical Associates of Central Virginia, Inc.

  • Internal Medicine Physician
  • Lynchburg, VA
  • NPI 1912970260
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1255728648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E MAIN ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045020",
            "telephone_number": "410-341-3420",
            "fax_number": "410-341-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E MAIN ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045020",
            "telephone_number": "410-341-3420",
            "fax_number": "410-341-3397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7033 Worcester Hwy",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "MD",
            "postal_code": "218412149",
            "country_code": "US",
            "telephone_number": "410-341-3420",
            "fax_number": "410-341-3397",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "431 E Main St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218045018",
            "country_code": "US",
            "telephone_number": "410-341-3420",
            "fax_number": "410-341-3397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RACHEL",
        "middle_name": "ZIPPORAH",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R165710",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R165710",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R165710",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "BIRCKHEAD",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Traci Ann Church, CRNP
• Zachary Chylinski, LGPC
• Joseph Alan Cinderella, M.D.
• City of Salisbury
• Civic Health Services LLC (Mt Hermon Discount Pharmacy)
• Amanda Clarke, CRNP
• Nattile Clarke, FNP-BC
• Donald E. Clayton, CRNP-F
• Jerry James Clayville, CRNP
• Clearway Anesthesia Services NE LLC

• Psychiatric/Mental Health Nurse Practitioner in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.