Wanda Lu Clark, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

509539 Issued in TX

Practice address

3113 Ross St
Amarillo, TX 79103-2700

Phone

(806) 374-7341

Fax

(806) 322-0533

NPI assigned

Jul 19, 2005

Last updated

Mar 24, 2020By 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 2

Medicare fee-for-service enrollment

Enrolled in TX

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

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.

• Amarillo Medical Group LLC

  • General Practice Physician
  • Amarillo, TX
  • NPI 1952573461
  NPD (past)
• FMC Clinics, P.a.

  dba dba Living Well Express Care

  • Family Medicine Physician
  • Amarillo, TX
  • NPI 1578756771
  NPD (past)
• FMC Medical Foundation, Inc

  dba FMC Canyon

  • Family Medicine Physician
  • Canyon, TX
  • NPI 1619902848
  NPD (past)
• High Plains Medical Group, LLC

  • General Practice Physician
  • Amarillo, TX
  • NPI 1982935771
  NPD (past)
• Panhandle Emergency Physicians, P.a.

  • Emergency Medicine Physician
  • Amarillo, TX
  • NPI 1629020870
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1356340681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W 8TH ST",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790726737",
            "telephone_number": "806-293-8561",
            "fax_number": "806-293-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 ROSS ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791032700",
            "telephone_number": "806-374-7341",
            "fax_number": "806-322-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WANDA",
        "middle_name": "LU",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "509539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142123201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "85N188",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jarrod Clark, PHARMD
• Kathleen Anne Clark, M.D.
• Summer Clark, M.D.
• Terry Clark, PHARM.D.
• Thomas R Clark, DC, CCSP, PA
• Lee Anne Clarke, RPH
• Class I Dental Associates, P.L.L.C
• Beverly J Clawson
• Chelsie Renee Clawson, LPC
• Katherine Rose Clay, LCSW-S

• Nurse Practitioner in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.