Vivian Clark, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024189931 Issued in VA

Practice address

11855 Parkgate Dr
Nokesville, VA 20181-2719

Phone

(571) 379-1228

NPI assigned

Apr 8, 2024

Sex

Female

Sole proprietor

No

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 VA

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

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.

• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  VA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1699528117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11855 PARKGATE DR",
            "city": "NOKESVILLE",
            "state": "VA",
            "postal_code": "201812719",
            "telephone_number": "571-379-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11855 PARKGATE DR",
            "city": "NOKESVILLE",
            "state": "VA",
            "postal_code": "201812719",
            "telephone_number": "571-379-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "VIVIAN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024189931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip William Barrere Jr., MD
• Bristow Care Services LLC
• Edson Brock, M.D.
• Cavery Therapy Center
• Cavery Wellness of Fairfax, LLC
• Rebecca Cleveland
• Gillian Clissold, LPC
• Emma Lee Converse, RBT
• Linea Duffus, ACNPC-AG
• Elka Home Services LLC

• Family Nurse Practitioner in Nokesville, VA
• Providers in Nokesville, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.