NPIMap

Individual provider Active NPI

Danielle Elizabeth Clark, FNP-C

  • Family Nurse Practitioner
  • Foley, AL
National Provider Identifier
1598492738
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-123831 Issued in AL
Practice address
1298 N McKenzie St
Foley, AL 36535-3503
Phone
(251) 971-3555
NPI assigned
Aug 8, 2022
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-123831 AL Primary

Addresses

Primary practice location

1298 N McKenzie St
Foley, AL 36535-3503

Mailing address

1298 N McKenzie St
Foley, AL 36535-3503
Phone (251) 949-3479

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address danielle.clark.1@1599.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919001146 AL Practitioner - Nurse Practitioner 0143605758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-South Home Care Services LLCGroup PAC ID 4385961093, 101 clinicians

Practice addresses (Care Compare)

2800 Dauphin St
Suite 103
Mobile, AL 36606-2400
Phone (251) 478-2789

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.97 of 100Reported as apm
Quality
75.95
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-123831ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Home Care Services, LLC CurrentSince Oct 7, 2024 Accepting new patients
Foley Clinic Corp CurrentSince Oct 17, 2022 Accepting new patients
Foley Clinic Corp CurrentSince Oct 17, 2022 Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Oct 7, 2024 Accepting new patients

Locations

2431 W Main St
Ste 1102
Dothan, AL 36301
Phone (334) 699-5780

2740 Headland Ave
Dothan, AL 36303
Phone (334) 792-3200

1298 N McKenzie St
Foley, AL 36535
Phone (251) 424-1160

161 W Peachtree Ave
Foley, AL 36535
Phone (251) 943-5511

101 E 15th Ave
Gulf Shores, AL 36542
Phone (251) 962-1250

2800 Dauphin St
Ste 103
Mobile, AL 36606
Phone (251) 478-2789

Interoperability endpoints

  • Direct secure messaging: danielle.clark.1@1599.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1599/brand/1/csg/341/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1598492738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1298 N MCKENZIE ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365353503",
            "telephone_number": "251-949-3479",
            "fax_number": "251-952-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1298 N MCKENZIE ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365353503",
            "telephone_number": "251-971-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DANIELLE",
        "middle_name": "ELIZABETH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-123831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "danielle.clark.1@1599.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1298 N McKenzie St",
            "city": "Foley",
            "state": "AL",
            "country_code": "US",
            "postal_code": "365353503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

Verify at the official NPI Registry.