Active NPI
Carol W Clark, RN, BSN
- College Health Registered Nurse
- Fort Collins, CO
National Provider Identifier
1346532751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- College Health Registered Nurse
- License
- 84-6000-545
- Practice address
- 600 South Drive
Fort Collins, CO 80523 - Phone
- (970) 491-7121
- NPI assigned
- May 4, 2011
- 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 |
|---|---|---|---|---|
| College Health Registered Nurse | 163WC1400X | 84-6000-545 | CO | Primary |
Addresses
Primary practice location
600 South Drive
Fort Collins, CO 80523
Mailing address
600 South Drive
Fort Colloins, CO 80523
Phone (970) 491-7121
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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84-6000-545 | CO | MD | College Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304467200000",
"number": "1346532751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 SOUTH DRIVE",
"city": "FORT COLLOINS",
"state": "CO",
"postal_code": "80523",
"telephone_number": "970-491-7121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 SOUTH DRIVE",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "80523",
"telephone_number": "970-491-7121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CAROL",
"middle_name": "W",
"name_prefix": "Mrs.",
"credential": "RN, BSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-04",
"last_updated": "2011-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1400X",
"taxonomy_group": "",
"desc": "Registered Nurse, College Health",
"state": "CO",
"license": "84-6000-545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.