Rachel Nacole Clark

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2018001797 Issued in MO

Practice address

1000 W 10TH St
Rolla, MO 65401-2905

Phone

(573) 458-7800

NPI assigned

Feb 1, 2018

Sex

Female

Sole proprietor

Yes

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 MO

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

Physician Assistant

Practice roles

Locations

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.

• Phelps County Regional Medical Center

  • General Acute Care Hospital
  • Rolla, MO
  • NPI 1891766051
  Medicare reassignment
• Phelps County Regional Medical Center

  • Rural Health Clinic/Center
  • Salem, MO
  • NPI 1194077701
  NPD
• Phelps County Regional Medical Center

  • Rural Health Clinic/Center
  • Rolla, MO
  • NPI 1366066037
  NPD

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1386142685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 ARLINGTON RD",
            "city": "NEWBURG",
            "state": "MO",
            "postal_code": "655509063",
            "telephone_number": "573-465-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-458-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RACHEL",
        "middle_name": "NACOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2018001797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Choices for People Center for Citizens With Disabilities Inc
• Choices for People Center for Citizens With Disabilities Inc
• Choudhrymd, LLC
• Christopher O Baldwin, MD LLC
• Christopher O. Baldwin M.D.,LLC
• Brett Benson Clayton, PA-C
• Clear Water Therapy
• Kathi D. Clement, MD
• Clinical Research of the Ozarks, Inc.
• Sellas Pecos Coble, D.O.

• Medical Physician Assistant in Rolla, MO
• Providers in Rolla, MO by specialty
• Medical Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.