Individual provider Active NPI

Phillipa Clarkson

  • Registered Nurse
  • Conroe, TX
National Provider Identifier
1609353523
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
869102 Issued in TX
Practice address
602 W Semands St
Conroe, TX 77301-1867
Phone
(936) 756-5598
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 869102 TX Primary

Addresses

Primary practice location

602 W Semands St
Conroe, TX 77301-1867

Mailing address

26214 Bright Dawn CT
Katy, TX 77494-6458
Phone (571) 201-7117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
869102TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Pediatric Home Care LLC Past Accepting new patients

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": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1609353523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26214 BRIGHT DAWN CT",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946458",
            "telephone_number": "571-201-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W SEMANDS ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011867",
            "telephone_number": "936-756-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKSON",
        "first_name": "PHILLIPA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "869102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.