Active NPI
Rebecca Uma Clark, FNP, NP-C, ARNP
- Critical Care Medicine Nurse Practitioner
- Melbourne, FL
National Provider Identifier
1295107035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Nurse Practitioner
- License
- APRN9294102
- Practice address
- 1314 Oak St
Melbourne, FL 32901 - Phone
- (321) 727-7992
- NPI assigned
- Oct 20, 2015
- Last updated
- Apr 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Nurse Practitioner | 363LC0200X | APRN9294102 | FL | Primary |
Addresses
Primary practice location
1314 Oak St
Melbourne, FL 32901
Mailing address
1314 Oak St
Melbourne, FL 32901-3111
Phone (321) 727-7992
Other practice location 1
1314 Oak St
Melbourne, FL 32901
Phone (321) 727-7992
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlantis Urgent Care, LLC | Current | Accepting new patients |
Locations
2254 Highway A1A
Indian Harbour Beach, FL 32937
Phone (321) 626-0994
Organizations & group practices 1
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.
-
dba Atlantis Urgent Care
- Urgent Care Clinic/Center
- Indian Harbour Beach, FL
- NPI 1821280579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555459200000",
"number": "1295107035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1314 OAK ST",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013111",
"telephone_number": "321-727-7992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1314 OAK ST",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "32901",
"telephone_number": "321-727-7992"
}
],
"practiceLocations": [
{
"address_1": "1314 Oak St",
"address_purpose": "LOCATION",
"city": "Melbourne",
"state": "FL",
"postal_code": "32901",
"country_code": "US",
"telephone_number": "321-727-7992",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARK",
"first_name": "REBECCA",
"middle_name": "UMA",
"name_prefix": "Miss",
"credential": "FNP, NP-C, ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-20",
"last_updated": "2019-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LC0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Critical Care Medicine",
"state": "FL",
"license": "APRN9294102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.