Karla Denise Clubine, FNP/PNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

128465 Issued in MO

Practice address

130 E Lockling St
Brookfield, MO 64628-2337

Phone

(660) 258-1050

Fax

(660) 258-1052

NPI assigned

Nov 4, 2005

Last updated

Dec 5, 2008By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

General John J Pershing Memorial Hospital AssociationGroup PAC ID 2860306750, shared by 5 NPIs, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• General John J Pershing Memorial Hospital Association

  dba Meadville Medical Clinic

  • Rural Health Clinic/Center
  • Meadville, MO
  • NPI 1285995944

  Contracted Managing Employee, Corporate Director

  CMS ownership
• General John J Pershing Memorial Hospital Association

  dba Pershing Memorial Hospital

  • Critical Access Hospital
  • Brookfield, MO
  • NPI 1417991159

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• General John J Pershing Memorial Hospital Association

  dba Communtiy Medical Associates

  • Rural Health Clinic/Center
  • Brookfield, MO
  • NPI 1487616256

  Contracted Managing Employee, Corporate Director

  CMS ownership
• General John J Pershing Memorial Hospital Association

  dba Pershing Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Brookfield, MO
  • NPI 1639197361

  Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• General John J Pershing Memorial Hospital Association

  dba Pershing Memorial Hospital

  • Critical Access Hospital
  • Brookfield, MO
  • NPI 1417991159
  Medicare reassignment NPD
• General John J Pershing Memorial Hospital Association

  dba Communtiy Medical Associates

  • Rural Health Clinic/Center
  • Brookfield, MO
  • NPI 1487616256
  Medicare reassignment NPD
• General John J Pershing Memorial Hospital Association

  dba Pershing Memorial Hospital

  • Primary Care Clinic/Center
  • Brookfield, MO
  • NPI 1982612461
  Medicare reassignment NPD

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228435200000",
    "number": "1265423461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22320 HIGHWAY M",
            "city": "BRUNSWICK",
            "state": "MO",
            "postal_code": "652362205",
            "telephone_number": "660-272-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E LOCKLING ST",
            "city": "BROOKFIELD",
            "state": "MO",
            "postal_code": "646282337",
            "telephone_number": "660-258-1050",
            "fax_number": "660-258-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUBINE",
        "first_name": "KARLA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "FNP/PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2008-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "128465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Brown, RD/LD
• Kristen Marie Butterfield, RPT
• Gail Calvert, FNP-BC
• Audra Carriker, PHARM D
• Brian Alan Casebolt
• Minerva C Concepcion-Rivera, MD
• Alexander Cosby, PHARMD
• Amy Creason, FNP
• Creative Pathways Residential Supports
• Michael R Crist, D.O.

• Family Nurse Practitioner in Brookfield, MO
• Providers in Brookfield, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.