Active NPI
Mary Ann Snyder Clark, CRNP
- Family Nurse Practitioner
- York, PA
National Provider Identifier
1629006010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- SP008753
- Practice address
- 300 Pine Grove Commons
York, PA 17403-5176 - Phone
- (717) 851-5736
- Fax
- (717) 851-6162
- NPI assigned
- Jun 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP008753 | PA | Primary |
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | SP008753 | PA |
Addresses
Primary practice location
300 Pine Grove Commons
York, PA 17403-5176
Mailing address
1803 Mount Rose Ave
Suite B3
York, PA 17403-3026
Phone (717) 851-1405
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102499 | Other | PA | JOHNS HOPKINS |
| 1551918 | Other | PA | GATEWAY-WMG |
| 50054751 | Other | PA | CAPITAL BLUE CROSS-WMG |
| 648377 | Other | MD | CAREFIRST MD BCBS |
Other names 1
- Mary Ann E Clark
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP008753 | PA | MD | Hospice and Palliative Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1629006010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1803 MOUNT ROSE AVE",
"address_2": "SUITE B3",
"city": "YORK",
"state": "PA",
"postal_code": "174033026",
"telephone_number": "717-851-1405",
"fax_number": "717-851-6162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PINE GROVE COMMONS",
"city": "YORK",
"state": "PA",
"postal_code": "174035176",
"telephone_number": "717-851-5736",
"fax_number": "717-851-6162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "MARY ANN",
"middle_name": "SNYDER",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SP008753",
"primary": true
},
{
"code": "207RH0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": "PA",
"license": "SP008753",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHNS HOPKINS",
"identifier": "102499",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY-WMG",
"identifier": "1551918",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS-WMG",
"identifier": "50054751",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST MD BCBS",
"identifier": "648377",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY ANN",
"last_name": "CLARK",
"middle_name": "E",
"credential": "CRNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.