Active NPI
Jennifer M Clark, CRNP
- Family Nurse Practitioner
- Littlestown, PA
National Provider Identifier
1407186554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- SP010597
- Practice address
- 300 W King St
Suite C
Littlestown, PA 17340-1446 - Phone
- (717) 339-2390
- Fax
- (717) 359-4178
- NPI assigned
- Jan 12, 2010
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP010597 | PA | Primary |
Addresses
Primary practice location
300 W King St
Suite C
Littlestown, PA 17340-1446
Mailing address
3421 Concord Rd
York, PA 17402-9001
Phone (717) 339-2390
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 960064 | Other | MD | CAREFIRST MD BCBS |
| 1587216 | Other | PA | GATEWAY-WMG |
| 2499067 | Other | PA | HIGHMARK BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
300 W King St
Suite C
Littlestown, PA 17340-1446
Phone (717) 339-2390
Hospital & facility affiliations
- Wellspan Vna Home Care
- Gettysburg Hospital
- Wellspan York Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspan Medical Group | Current | Accepting new patients | |
| Wellspan Medical Group | Current | Accepting new patients | |
| Wellspan Medical Group | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
300 W King St
Ste C
Littlestown, PA 17340
Phone (717) 339-2390
3421 Concord Rd
York, PA 17402
Phone (717) 851-2441
25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250
1600 S George St
York, PA 17403
Phone (717) 848-3615
Interoperability endpoints
- jclark103079@wellspan.direct-ci.com
Organizations & group practices 4
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.
-
- Gastroenterology Physician
- York, PA
- NPI 1669770004
-
- Pediatric Surgery Physician
- York, PA
- NPI 1104799428
-
- Endocrinology, Diabetes & Metabolism Physician
- York, PA
- NPI 1578623781
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gettysburg, PA
- NPI 1265466957
-
- Home Health Agency
- York, PA
- NPI 1437172301
-
- General Acute Care Hospital
- York, PA
- NPI 1326060492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1407186554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 CONCORD RD",
"city": "YORK",
"state": "PA",
"postal_code": "174029001",
"telephone_number": "717-339-2390",
"fax_number": "717-359-4178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W KING ST",
"address_2": "SUITE C",
"city": "LITTLESTOWN",
"state": "PA",
"postal_code": "173401446",
"telephone_number": "717-339-2390",
"fax_number": "717-359-4178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JENNIFER",
"middle_name": "M",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-12",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SP010597",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST MD BCBS",
"identifier": "960064",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY-WMG",
"identifier": "1587216",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "2499067",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Littlestown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.