Individual provider Active NPI

Eunice Park-Clinton, CRNP

  • Gerontology Nurse Practitioner
  • Lansdale, PA
National Provider Identifier
1275213183
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP027553 Issued in PA
Practice address
2235 Ayreshire Dr
Lansdale, PA 19446-5822
Phone
(267) 471-5126
NPI assigned
Jul 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X SP027553 PA Primary

Addresses

Primary practice location

2235 Ayreshire Dr
Lansdale, PA 19446-5822

Mailing address

2235 Ayreshire Dr
Lansdale, PA 19446-5822
Phone (267) 471-5126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP027553PAMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1275213183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 AYRESHIRE DR",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194465822",
            "telephone_number": "267-471-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 AYRESHIRE DR",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194465822",
            "telephone_number": "267-471-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK-CLINTON",
        "first_name": "EUNICE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP027553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.