Individual provider Active NPI

Teresa Ann Clark, FNP-C

  • Family Nurse Practitioner
  • Palm Harbor, FL
National Provider Identifier
1497429948
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
348054 Issued in NY
Practice address
3825 Countryside Blvd N
Palm Harbor, FL 34684-4928
Phone
(727) 784-2848
NPI assigned
Aug 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 348054 NY Primary

Addresses

Primary practice location

3825 Countryside Blvd N
Palm Harbor, FL 34684-4928

Mailing address

3825 Countryside Blvd N
Palm Harbor, FL 34684-4928
Phone (727) 784-2848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210831003702 NY Practitioner - Nurse Practitioner 0143626036 Reassigns benefits to 2 organizations
I20230817001044 FL Practitioner - Nurse Practitioner 0143626036 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mana Health Partners PAGroup PAC ID 3971952813, 102 clinicians

Practice addresses (Care Compare)

3825 Countryside Blvd N
Palm Harbor, FL 34684-4928
Phone (732) 552-8922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Jun 1, 2022 Accepting new patients
Curana Health of Florida LLC CurrentSince Dec 13, 2023 Accepting new patients
Sunshine Health Partners, LLC CurrentSince Dec 13, 2023 Accepting new patients
Curana Health of New Mexico LLC CurrentSince Dec 13, 2023 Accepting new patients
Mana Health Partners PA CurrentSince Feb 2, 2025 Accepting new patients

Locations

2332 Galiano St
#2
Coral Gables, FL 33134
Phone (305) 998-0546

5200 NE 2nd Ave
Miami, FL 33137
Phone (305) 762-1387

991 Pondella Rd
North Ft Myers, FL 33903
Phone (239) 994-8809

80 W Lucerne Cir
Orlando, FL 32801
Phone (407) 839-5050

3825 Countryside Blvd N
Palm Harbor, FL 34684
Phone (727) 781-1402

1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336

1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803

338 Whitesville Rd
Ste 103
Jackson, NJ 08527

1438 Western Ave
Albany, NY 12203
Phone (518) 542-1393

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/19831/brand/2/csg/1/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1497429948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 COUNTRYSIDE BLVD N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346844928",
            "telephone_number": "727-784-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 COUNTRYSIDE BLVD N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346844928",
            "telephone_number": "727-784-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "348054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.