Cathy Vanessa Clark

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11006110 Issued in FL

Practice address

818 Baybreeze LN
Altamonte Springs, FL 32714-7502

Phone

(407) 756-0717

NPI assigned

Jun 1, 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

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  FL

  Medicare reassignment

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675468800000",
    "number": "1295474880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 BAYBREEZE LN",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147502",
            "telephone_number": "407-756-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 BAYBREEZE LN",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147502",
            "telephone_number": "407-756-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CATHY",
        "middle_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2023-02-04",
        "certification_date": "2023-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11006110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Nicole Cintron
• Citrus Surgical Group PA (Citrus Surgical P. A.)
• Christine Ciulla
• Clara's Legacy Care LLC
• Clarity Behavioral Health Inc
• James Elliott Clark, MD
• Krystin Clark
• Tom H Clark, RPH
• Christine Nguyen Clarke, PHARM.D.
• Danielle Clarke, D.C.

• Nurse Practitioner in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2023; 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.

Verify at the official NPI Registry.