Janell Lanice Clark, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP010694 Issued in PA

Practice address

1738 W Cheltenham Ave
Philadelphia, PA 19126-1546

Phone

(215) 548-3390

Fax

(215) 549-8998

NPI assigned

Apr 23, 2010

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

Other names 1

• Janell Lanice Butts Other name

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 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

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Sunlyte Treatment Centers

  • Medical Specialty Clinic/Center
  • Philadelphia, PA
  • NPI 1033704630

  Adult Health

  Medicare reassignment NPD Authorized official
• Clinical Health Care Associates of New Jersey, PC

  • Pulmonary Disease Physician
  • Cherry Hill, NJ
  • NPI 1508019241
  Medicare reassignment NPD
• Clinical Health Care Associates of New Jersey, P.C.

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1447260435
  NPD
• Clinical Health Care Associates of New Jersey, PC

  • Diagnostic Radiology Physician
  • Cherry Hill, NJ
  • NPI 1821447103
  NPD

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1598082059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 W CHELTENHAM AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191261546",
            "telephone_number": "215-548-3390",
            "fax_number": "215-549-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 W CHELTENHAM AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191261546",
            "telephone_number": "215-548-3390",
            "fax_number": "215-549-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JANELL",
        "middle_name": "LANICE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP010694",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP010694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANELL",
            "last_name": "BUTTS",
            "middle_name": "LANICE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cynthia Anne Clark, CRNP
• Derek Anthony Clark
• Fabienne A. Clark
• Irene Maria Clark, LCSW
• Jae H Clark, ATC, LAT
• Jasmen Clark
• Jasmine Clark
• Jessica Clark
• Jonathan Michael Clark, MA, MS, LPC, NBCC
• Katie D Clark, RD, LDN

• Adult Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.