Zina Renee Clark

Primary specialty

Gerontology Registered NurseTaxonomy code 163WG0600X

License

0000085468 Issued in TN

Practice address

7264 Hunters Tree Dr
Memphis, TN 38125-4807

Phone

(901) 292-4407

NPI assigned

Jan 19, 2021

Last updated

Jan 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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.

• Clark Mental Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
  • NPI 1639869050
  NPD Authorized official
• Minding Your Mental Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
  • NPI 1619734134
  NPD

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1508456096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7264 HUNTERS TREE DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381254807",
            "telephone_number": "901-292-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7264 HUNTERS TREE DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381254807",
            "telephone_number": "901-292-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ZINA",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "TN",
            "license": "0000085468",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "TN",
            "license": "0000085468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Clark, NP
• Shawna Clark, D.D.S.
• Tamara M Clark
• Trent Murray Clark, DO
• William Ray Clark II, PA-C
• Audrey F Clarke, LPN
• Catherine Jane Clarke, MD
• Christopher Andrew Clarke, O.D.
• Jeannette A Clarke, M.A
• Travis Jonathan Clarke, MD

• Gerontology Registered Nurse in Memphis, TN
• Providers in Memphis, TN by specialty
• Gerontology Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.