Susan Carole Clark

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

496363 Issued in NY

Practice address

1 School Dr
Penn Yan, NY 14527-1081

Phone

(315) 536-2331

NPI assigned

Dec 6, 2022

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1265143887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SCHOOL DR",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271081",
            "telephone_number": "315-536-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SCHOOL DR",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271081",
            "telephone_number": "315-536-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SUSAN",
        "middle_name": "CAROLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "496363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlene L Chilson, MS
• Carrilee Rose Christensen, RN
• Mary Ann Christensen, P.T.
• Sara L Christensen, R.N.
• Brittany Clancy, DPT
• Carol H Clendenin, LCSW-R
• Mark Collinsworth, RDH
• Marlene Ann Comfort, NP
• Mary Barbara Corwin, RN
• Constance Covert, LCSW

• Registered Nurse in Penn Yan, NY
• Providers in Penn Yan, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.