Anita Clark, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

1-020410 Issued in AL

Practice address

1203 US Highway 98
Suite 2a
Daphne, AL 36526-4277

Phone

(251) 621-9167

NPI assigned

Jun 22, 2009

Last updated

Jun 22, 2009By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Alabama Psychiatric Services PC

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1033159306
  NPD (past)

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1578790176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2868 ACTON RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432502",
            "telephone_number": "205-968-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 US HIGHWAY 98",
            "address_2": "SUITE 2A",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365264277",
            "telephone_number": "251-621-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANITA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-020410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clears Clinic Corporation
• Coastal Chiropractic L.L.C.
• Coastal Counseling & Consulting, LLC
• Coastal Counseling and Consulting, LLC

• Psychiatric/Mental Health Registered Nurse in Daphne, AL
• Providers in Daphne, AL by specialty
• Psychiatric/Mental Health Registered Nurse in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.