Mary Theresa McGuire Clark, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F1014276 Issued in MN

Practice address

150 Emerson Ave E
West Saint Paul, MN 55118-2535

Phone

(651) 241-1800

NPI assigned

Oct 9, 2014

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota Womens Care PAGroup PAC ID 9638329394, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FAHCDA

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.

• Minnesota Women'S Care, P.a.

  • Obstetrics & Gynecology Physician
  • Maplwood, MN
  • NPI 1518221779
  Medicare reassignment Care Compare group NPD
• Comprehensive Healthcare for Women, PA

  • Obstetrics & Gynecology Physician
  • Woodbury, MN
  • NPI 1841235595
  NPD

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1265836928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5439 UPPER 147TH ST W",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246665",
            "telephone_number": "612-730-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 EMERSON AVE E",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551182535",
            "telephone_number": "651-241-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARY",
        "middle_name": "THERESA MCGUIRE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "F1014276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mclark23572@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "150 Emerson Ave E",
            "city": "West Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551182535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nasra D Budul
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• Edwin R Burrell, MD
• Busy Bee Home Health Care
• Michaela Erin Calhoun, C.C.A.
• Combined Nursing Services LLC
• Connect HSS
• Dakota Communities Inc
• Peggy Darmody, CRC
• Aubrey Davis, APRN-CNP

• Family Nurse Practitioner in West Saint Paul, MN
• Providers in West Saint Paul, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.