Benjamin S Clark, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-098021 Issued in AL

Practice address

108C McMeans Ave
Bay Minette, AL 36507-3130

Phone

(251) 445-3391

Fax

(251) 445-3722

NPI assigned

May 18, 2006

Last updated

Aug 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Care 59 PCGroup PAC ID 6002274925, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Urgent Care 59, PC

  • Rural Health Clinic/Center
  • Bay Minette, AL
  • NPI 1093415671
  Medicare reassignment Care Compare group NPD
• Baldwin Emergency Physicians, P.C..

  • Emergency Medicine Physician
  • Fairhope, AL
  • NPI 1154378271
  Medicare reassignment NPD
• Mobile Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Mobile, AL
  • NPI 1881934982
  Medicare reassignment NPD

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1497708572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108C MCMEANS AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365073130",
            "telephone_number": "251-445-3391",
            "fax_number": "251-445-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108C MCMEANS AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365073130",
            "telephone_number": "251-445-3391",
            "fax_number": "251-445-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BENJAMIN",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-098021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318149",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda E Carter
• Stacey D Carter, R.PH.
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• Jacqueline Childs, OTRL
• Chiropractic Care Center, LLC
• Courtney Clemmons
• Kerry Alan Clewell, ATC
• Martha Renee Collier, LPTA
• Wesley Heath Corbin, D.C.
• Megan Trehern Courtney, M.D.

• Family Nurse Practitioner in Bay Minette, AL
• Providers in Bay Minette, AL by specialty
• Family Nurse Practitioner in Alabama

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