Rachel Leah Clark, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F07230175 Issued in FL

Practice address

369 Deer Run Rd
Palm Bay, FL 32909-1125

Phone

(386) 451-6703

NPI assigned

Sep 11, 2023

Last updated

Sep 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Rachel Leah Davis Former name

Medicare fee-for-service enrollment

Enrolled in FL

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Florida Spine and PainGroup PAC ID 7618396268, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parrish Medical Center Hospital, Titusville, FL, CCN 100028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Central Florida Spine and Pain LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Melbourne, FL
  • NPI 1851904916
  Medicare reassignment Care Compare group NPD
• Orthopedic Center of Titusville PL

  • Specialist
  • Titusville, FL
  • NPI 1043498595
  NPD (past)

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

• North Brevard County Hospital District

  dba Parrish Medical Center

  • General Acute Care Hospital
  • Titusville, FL
  • NPI 1053424648
  Care Compare affiliation

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1629855036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 DEER RUN RD",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329091125",
            "telephone_number": "864-516-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 DEER RUN RD",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329091125",
            "telephone_number": "386-451-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RACHEL",
        "middle_name": "LEAH",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F07230175",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9235916",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "DAVIS",
            "middle_name": "LEAH",
            "credential": "REGISTERED NURSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Ciampa
• Circles of Care, Inc.
• Clara's Angels
• Darius Clark
• Nanette Sebrena Clark
• Sandra Clarke
• Cecilia V Claxton
• Brenda K Clemens, NP
• Nikisha Nicole Clementin, M.ED. CCC-SLP
• Climb, Bcba Services, Inc

• Family Nurse Practitioner in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.