Carolyn B Clark, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP1360702 Issued in FL

Practice address

1217 S East Ave Ste 104
Sarasota, FL 34239-2350

Phone

(941) 365-0433

Fax

(941) 954-2064

NPI assigned

Sep 23, 2005

Last updated

Dec 19, 2019By 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

Other identifiers 1

Other names 1

• Carolyn Bennett Former name

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

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: carolc@hvcs.directbygreenway.com
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73573

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.

• Heart & Vascular Center of Sarasota Inc

  • Interventional Cardiology Physician
  • Sarasota, FL
  • NPI 1033174453
  Medicare reassignment NPD

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1316933567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5699",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342775699",
            "telephone_number": "941-365-0433",
            "fax_number": "941-954-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 S EAST AVE STE 104",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392350",
            "telephone_number": "941-365-0433",
            "fax_number": "941-954-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CAROLYN",
        "middle_name": "B",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1360702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "753072541",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "BENNETT",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Pearson Clack, M.D
• Claire L Fadely DC LLC (Coastal Chiropractic and Wellness)
• Clancy Acupuncture and Oriental Medicine
• David Allen Clapp, M.A., LMHC
• Michael P Clare, MD
• Cassandra Clark, DC
• Cynthia Clark, L.AC.
• Roshunya Shavon Clark, ARNP
• Alane Renee Clarke, L.D.O.
• Marlene Clarke, NP-C

• Nurse Practitioner in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.

Verify at the official NPI Registry.