Nathan Blaine Clark, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3006900 Issued in KY

Practice address

400 Industrial Road
Suite a
Murray, KY 42071

Phone

(270) 761-9355

Fax

(270) 761-9356

NPI assigned

Apr 8, 2011

Last updated

Feb 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: nathan.clark@jktmp.eclinicaldirectplus.com

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.

• Healthworks Medical, LLC

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1235649971
  NPD (past)
• James Kyle Turnbo M.D. PSC

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1457453540
  NPD (past)
• West End Imaging, PLLC

  • Diagnostic Radiology Physician
  • Paducah, KY
  • NPI 1619559705
  NPD (past)
• Healthworks Medical LLC

  • Interventional Pain Medicine Physician
  • Summerville, SC
  • NPI 1578954426
  NPD (past)

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1578853883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 MELROSE DR",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420714700",
            "telephone_number": "270-293-0443",
            "fax_number": "270-761-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INDUSTRIAL ROAD",
            "address_2": "SUITE A",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "42071",
            "telephone_number": "270-761-9355",
            "fax_number": "270-761-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NATHAN",
        "middle_name": "BLAINE",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-08",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3006900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "3006900",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond J Charette, M.D.
• Charles D. Tucker, M.D., PSC (Murray Surgery Center)
• Mary Elisabeth Chase, D.C.
• Ryan Wesley Chasseur, PHARMD
• Hollis J Clark, MD
• Tia A Clark, APRN, FNP-C
• Jacob Clevenger, OTR/L
• Aliya Grace Clough, CCC-SLP
• Chadwick Hunter Cochran, PHARM.D.
• Katrina A Coffelt, LPCC

• Family Nurse Practitioner in Murray, KY
• Providers in Murray, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.