Todd L Clark, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9827 Issued in CT

Practice address

140 Sherman St FL 2
2ND Floor
Fairfield, CT 06824-5849

Phone

(203) 759-8077

NPI assigned

Aug 2, 2021

Last updated

Jan 21, 2024By the provider in NPPES

Sex

Male

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 CT

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TLC & Care LLC

  • Pain Clinic/Center
  • Fairfield, CT
  • NPI 1508541350
  Medicare reassignment NPD Authorized official
• TLC & Mental Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairfield, CT
  • NPI 1659289684
  Authorized official Same address or phone

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705795200000",
    "number": "1407529738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SHERMAN ST FL 2",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245849",
            "telephone_number": "203-759-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SHERMAN ST FL 2",
            "address_2": "2ND FLOOR",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245849",
            "telephone_number": "203-759-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TODD",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2024-01-21",
        "certification_date": "2024-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "9827",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "9827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ciullo, APRN
• Brian Clancy
• Clarivision-Advanced Eye Care
• Bridget Blake Clark, LPC
• Courtney Clark, PSYD
• Clean Rxeach LLC
• Clear Life Counseling and Wellness,PLLC
• Stephanie H Clines, PHD, LAT, ATC
• Candace Clinger, LCSW
• CMS Therapy Group, LLC

• Family Nurse Practitioner in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2024; 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.

Verify at the official NPI Registry.