Katherine Clark, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F307625-1 Issued in NY

Practice address

51 W 51St St
Suite 100
New York, NY 10019-6113

Phone

(212) 326-5705

Fax

(212) 326-5700

NPI assigned

Mar 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347
  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD
• Trustees of Columbia University in the City of New York

  • Dermatology Physician
  • New York, NY
  • NPI 1538269444
  NPD (past)

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1326432717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 W 51ST ST",
            "address_2": "SUITE 100",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100196113",
            "telephone_number": "212-326-5705",
            "fax_number": "212-326-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 W 51ST ST",
            "address_2": "SUITE 100",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100196113",
            "telephone_number": "212-326-5705",
            "fax_number": "212-326-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHERINE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "686947-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307625-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanann Clark, PHYSICIAN ASSISTANT
• Jenifer Clark, PHD
• Joanne N.S. Clark, LCSW
• John F.J. Clark III
• Joy Arlene Clark, M.D.
• Katherine E Clark
• Kristen Clark, MD
• Madison R Clark, NP
• Mark Clark, MD
• Mary K. Clark, NP

• Adult Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.