Rhonda Iddins Clark, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95006850 Issued in CA

Practice address

1402 Bailey Ave
Needles, CA 92363-3104

Phone

(760) 326-0222

Fax

(760) 326-0221

NPI assigned

Apr 1, 2014

Last updated

Apr 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Rhonda Iddins Kennedy Former name

Medicare fee-for-service enrollment

Enrolled in TN, AZ2 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

Specialty

Nurse Practitioner

Education

East Tennessee State University Quillen College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Rehab Consultants PLLCGroup PAC ID 6800220682, 251 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.06 of 100Reported as group

Quality

68.27

Promoting interoperability

100

Improvement activities

40

Cost

78.59

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Comprehensive Rehab Consultants PLLC

  dba Comprehensive Rehab Consultants LLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  AZ, Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Nextcare Arizona LLC

  dba NextCare Urgent Care

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1043371826
  Medicare reassignment NPD
• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment NPD
• Lakeside Orthopedic Institute LLC

  • Orthopaedic Surgery Physician
  • Lake Havasu City, AZ
  • NPI 1275564916
  NPD
• Lakeside Orthopedic Institute LLC

  dba Lakeside CT

  • Diagnostic Radiology Physician
  • Lake Havasu City, AZ
  • NPI 1528870243
  NPD
• Lakeside Orthopedic Institute LLC

  • Orthopaedic Surgery Physician
  • Lake Havasu City, AZ
  • NPI 1679764229
  NPD
• Nextcare Arizona I JV LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1114798071
  NPD
• Summit Medical Group, PLLC

  dba Charles H. Bozeman, II, MD

  • Family Medicine Physician
  • Sevierville, TN
  • NPI 1306915327
  NPD
• Tri-State Community Healthcare Center

  • Federally Qualified Health Center (FQHC)
  • Mohave Valley, AZ
  • NPI 1841703253
  NPD
• Lakeside Orthopedic Institute LLC

  dba Lakeside Mobile Imaging

  • Mobile Radiology Clinic/Center
  • Lake Havasu City, AZ
  • NPI 1548936164
  NPD (past)
• Lakeside Orthopedic Institute LLC

  dba Lakeside MRI

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Lake Havasu City, AZ
  • NPI 1912524380
  NPD (past)
• Lakeside Orthopedic Institute, LLC

  • Orthopaedic Surgery Physician
  • Bullhead City, AZ
  • NPI 1245965581
  NPD (past)

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1528486172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 BAILEY AVE",
            "city": "NEEDLES",
            "state": "CA",
            "postal_code": "923633104",
            "telephone_number": "760-326-0222",
            "fax_number": "760-326-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 BAILEY AVE",
            "city": "NEEDLES",
            "state": "CA",
            "postal_code": "923633104",
            "telephone_number": "760-326-0222",
            "fax_number": "760-326-0221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 S Highway 95",
            "address_purpose": "LOCATION",
            "city": "Mohave Valley",
            "state": "AZ",
            "postal_code": "864408519",
            "country_code": "US",
            "telephone_number": "928-768-7113",
            "fax_number": "928-768-9334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RHONDA",
        "middle_name": "IDDINS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18691",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009621",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "240243",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RHONDA",
            "last_name": "KENNEDY",
            "middle_name": "IDDINS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brad Clayton Barth, M.D.
• Billet Adhc Inc Needles
• Ian Anthony Butler, D.O.
• Camdin D Classen
• Michelle R. Chavez
• Colorado River Home Health
• Community Healthcare Partner, Inc (Colorado River Medical Center)
• Community Healthcare Partner, Inc (Colorado River Medical Center)
• Community Healthcare Partner, Inc. (Colorado River Medical Center)
• Community Healthcare Partner, Inc. (Colorado River Medical Center)

• Family Nurse Practitioner in Needles, CA
• Providers in Needles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.
• 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.