Jennifer Gayle Ries-Clark, FNPC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

219824 Issued in AZ

Practice address

8009 W Salter Dr
Peoria, AZ 85382-4440

Phone

(602) 663-8127

NPI assigned

Mar 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Honorhealth Medical Group, LLCGroup PAC ID 1557274057, 338 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations (25 of 35)

Interoperability endpoints

• Direct secure messaging: jriesclark510049@direct.honorhealth.com

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.

• Honorhealth Medical Group, LLC

  • Primary Care Clinic/Center
  • Peoria, AZ
  • NPI 1043851793
  Medicare reassignment Care Compare group NPD
• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1023693207
  NPD
• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1285338343
  NPD
• Honorhealth Medical Group, LLC

  dba Dearing Family Medicine

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1679876601
  NPD (past)

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1619435310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8009 W SALTER DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853824440",
            "telephone_number": "602-663-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8009 W SALTER DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853824440",
            "telephone_number": "602-663-8127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8009 W Salter Dr",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853824440",
            "country_code": "US",
            "telephone_number": "602-663-8127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIES-CLARK",
        "first_name": "JENNIFER",
        "middle_name": "GAYLE",
        "name_prefix": "Mrs.",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "219824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA ADVANCED PRACTICE LICENCE",
            "identifier": "219824",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE BOARD OF NURSING",
            "identifier": "RN157294",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Eugene Rider, M.D.
• Ridges at Peoria, LLC (Senita Ridge)
• Ridges at Peoria, LLC (Arbor Ridge)
• Ridges at Peoria, LLC (Garden Ridge)
• Emily Riefenhauser
• Daniel Mark Riesenberg, M.D.
• Austin J Rigby, DMD
• Megan Rigby, DNP
• Michelle Rigg
• Brandon Joseph Riley, PHARM.D., R.PH.

• Family Nurse Practitioner in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.