James M Clark, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R854948 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-6525

Fax

(601) 984-5151

NPI assigned

Feb 13, 2013

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in MS

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rapha Wellness and Primary Care, LLCGroup PAC ID 9830539261, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Rapha Wellness and Primary Care, LLC

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1457051591
  Medicare reassignment Care Compare group NPD
• Southern Medical Consultants LLC

  • Primary Care Nurse Practitioner
  • Ridgeland, MS
  • NPI 1215396577
  Medicare reassignment
• Trustcare Primary Care, LLC

  • Family Medicine Physician
  • Madison, MS
  • NPI 1174078554
  NPD (past)

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

• Sta-Home Health Agency of Jackson, Inc.

  • Home Health Agency
  • Clinton, MS
  • NPI 1356482749
  Care Compare affiliation

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1639418486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4402",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390474402",
            "telephone_number": "601-992-9898",
            "fax_number": "601-398-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6525",
            "fax_number": "601-984-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-13",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R854948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07876712",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Clark, PHARM D
• Brennan Naliyah Clark
• Brittany C Clark
• Donald Clark III, M.D.
• Elizabeth Clark
• Jenna Elizabeth Clark, NP
• Kimberly Clark
• Marva Clark, LSW
• Pamela Dixon Clark, LCSW
• Rhonica Clark, PCMHT

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.