Individual provider Active NPI

Danielle Elizabeth Clark, APRN

  • Family Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1699324566
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013722 Issued in KY
Practice address
1221 S Broadway
Lexington, KY 40504-2701
Phone
(859) 258-4000
Fax
(859) 258-6203
NPI assigned
Sep 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3013722 KY Primary

Addresses

Primary practice location

1221 S Broadway
Lexington, KY 40504-2701

Mailing address

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200

Other practice location 1

69 S Main St
Whitley City, KY 42653-6043
Phone (606) 376-7399

Other identifiers 1

IdentifierTypeStateIssuer
7100622120MedicaidKY

Other names 1

  • Danielle E Powell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20190925000866 KY Practitioner - Nurse Practitioner 1052641677 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Lexington Clinic PSCGroup PAC ID 3476457532, 329 clinicians

Practice addresses (Care Compare)

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000

Merit-based Incentive Payment System (MIPS)

Final score
47.05 of 100Reported as apm
Quality
54.1
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Kentucky, PLLC CurrentSince Oct 1, 2021 Accepting new patients
Fast Pace Kentucky PLLC Family CurrentSince Oct 1, 2021 Accepting new patients
New Lexington Clinic, PSC CurrentSince Oct 7, 2024 Accepting new patients
Unbridled Healthcare System LLC CurrentSince Jan 6, 2026 Accepting new patients
Unbridled Healthcare System LLC CurrentSince Jan 6, 2026 Accepting new patients
New Lexington Clinic PSC CurrentSince Oct 7, 2024 Accepting new patients
Lake Cumberland Physician Practices LLC CurrentSince Mar 1, 2023 Accepting new patients
Lake Cumberland Physician Practices LLC CurrentSince Mar 1, 2023 Accepting new patients
Lake Cumberland Physician Practices, LLC Current Accepting new patients
Lake Cumberland Surgery Center LP Past Accepting new patients

Locations

796 W Broadway St
Campbellsville, KY 42718
Phone (270) 572-4933

110 S 2nd St
Central City, KY 42330
Phone (270) 931-2059

1475 Nashville Rd
Franklin, KY 42134
Phone (270) 813-1111

1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181

222 N Main St
London, KY 40741
Phone (606) 389-5250

30 Tower Cir
Somerset, KY 42503
Phone (606) 451-8644

26 Oxford Way
Ste B
Somerset, KY 42503
Phone (606) 425-4298

163 Tower Cir
Somerset, KY 42503
Phone (606) 676-0786

Interoperability endpoints

  • FHIR API: https://97465a19-0dc7-4ef3-9aea-f72e472d3305.gastro.prod.fhir.ema-api.com/fhir/r4/
  • Direct secure messaging: danielle.clark.1@21269.direct.athenahealth.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1699324566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200",
            "fax_number": "859-258-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-4000",
            "fax_number": "859-258-6203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "69 S Main St",
            "address_purpose": "LOCATION",
            "city": "Whitley City",
            "state": "KY",
            "postal_code": "426536043",
            "country_code": "US",
            "telephone_number": "606-376-7399",
            "fax_number": "606-376-7397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DANIELLE",
        "middle_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100622120",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "POWELL",
            "middle_name": "E",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.