Katelyn Clarke, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F07220882 Issued in NY

Practice address

355 Main St
Johnson City, NY 13790-2050

Phone

(607) 798-1602

Fax

(607) 798-1605

NPI assigned

Dec 19, 2022

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Locations

Interoperability endpoints

• Direct secure messaging: npclarke@compwomen.medentdirect.com

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.

• Comprehensive Womens Health Care by Dhruv Agneshwar MD PC

  • Obstetrics & Gynecology Physician
  • Johnson City, NY
  • NPI 1770689051
  Medicare reassignment NPD

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1487366704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 MAIN ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902050",
            "telephone_number": "607-798-1602",
            "fax_number": "607-798-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 MAIN ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902050",
            "telephone_number": "607-798-1602",
            "fax_number": "607-798-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "KATELYN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F07220882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmed Faisal Chowdhury, MD
• Ishraq Chowdhury, DO
• Christian D. Tvetenstrand MD, PLLC
• Mia Cicoria-Timm
• Amber Cina
• David J Clovsky, LCSW R
• Deborah Cohen, M.D.
• Bonnie Jean Cole, OTR
• Kristie Lynn Coleman, RN
• Jamie Collins, PA

• Family Nurse Practitioner in Johnson City, NY
• Providers in Johnson City, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.