Individual provider Active NPI

Patricia Ann Clarke, CPNP

  • Pediatric Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1609157379
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
650133 Issued in TX
Practice address
333 N Santa Rosa St
San Antonio, TX 78207-3108
Phone
(210) 704-2187
Fax
(210) 704-3566
NPI assigned
Sep 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 650133 TX Primary

Addresses

Primary practice location

333 N Santa Rosa St
San Antonio, TX 78207-3108

Mailing address

315 N San Saba
Suite 1135
San Antonio, TX 78207-3154
Phone (210) 704-4275

Other names 1

  • Mrs. Patricia Clarke Rives Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
650133TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jul 14, 2014 Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1609157379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA",
            "address_2": "SUITE 1135",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073154",
            "telephone_number": "210-704-4275",
            "fax_number": "210-704-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-2187",
            "fax_number": "210-704-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "650133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "RIVES",
            "middle_name": "CLARKE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.