Clint P. Malcom, MH APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

110744 Issued in NE

Practice address

2315 W 39TH St
Unit #6
Kearney, NE 68845-8327

Phone

(308) 233-3847

Fax

(308) 233-5921

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hilary Ohrt, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Kearney, NE
  • NPI 1669728242
  Medicare reassignment

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.

• Serene Mental Health Clinic LLC

  • Adult Mental Health Clinic/Center
  • Kearney, NE
  • NPI 1184963126
  Medicare reassignment NPD
• Serene Mental Health Clinic LLC

  • Adult Mental Health Clinic/Center
  • Kearney, NE
  • NPI 1730946401
  NPD

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1689620650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 W 39TH ST",
            "address_2": "UNIT #6",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688458327",
            "telephone_number": "308-233-3847",
            "fax_number": "308-233-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 W 39TH ST",
            "address_2": "UNIT #6",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688458327",
            "telephone_number": "308-233-3847",
            "fax_number": "308-233-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOM",
        "first_name": "CLINT",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "credential": "MH APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "110744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S Maginnis, R.P. PHARM. D.
• James Michael Mahalek, MD
• Kati Mahalek, CRNA
• Stephanie Marie Mahony, PLMHP
• Making Choices Counseling
• Brian Thomas Malicky, DPT
• Brittney Maloley-Lewis, DO
• Rita Marie Maloley, LCSW
• Samantha Ann Malone
• Stacy Marie Malone

• Psychiatric/Mental Health Nurse Practitioner in Kearney, NE
• Providers in Kearney, NE by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.