McKenzie Clark

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1222573 Issued in TX

Practice address

6510 Hillcroft Ave Ste 200
Houston, TX 77081-4771

Phone

(713) 988-6677

NPI assigned

Jan 31, 2018

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 SC

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

Master of Science - Nursing, 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 and National Provider Directory roles.

• Fetter Health Care Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Charleston, SC
  • NPI 1003827304
  Medicare reassignment NPD
• Fetter Health Care Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Summerville, SC
  • NPI 1518454818
  Medicare reassignment NPD
• Fetter Health Care Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Moncks Corner, SC
  • NPI 1659872059
  Medicare reassignment NPD
• Fetter Health Care Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Charleston, SC
  • NPI 1982124301
  Medicare reassignment NPD
• Fetter Health Care Network Inc

  • Federally Qualified Health Center (FQHC)
  • Cross, SC
  • NPI 1396859823
  NPD
• Tribeca Pediatrics

  • Pediatrics Physician
  • Jersey City, NJ
  • NPI 1356000160
  NPD (past)
• Tribeca Pediatrics, PLLC

  • Pediatric Adolescent Medicine Physician
  • New York, NY
  • NPI 1588635171
  NPD (past)

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1528566932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 HILLCROFT AVE STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770814771",
            "telephone_number": "713-988-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 HILLCROFT AVE STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770814771",
            "telephone_number": "713-988-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1222573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latosha Clark
• Madeline Elizabeth Clark, MD
• Marie A. Clark, M.D.
• Marylou Clark
• Matthew David Clark, PHARM.D.
• Meaghann Clark, RPA-C
• Melanie Patrice Clark, M.A, LPC
• Michael Clark
• Molly Clark, P.T.
• Monica Andrea Clark, MD

• Pediatric Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; 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.