Active NPI
Louann Clark, ARNP
- Nurse Practitioner
- Dade City, FL
National Provider Identifier
1710940333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP3198092
- Practice address
- 14027 5TH St
Dade City, FL 33525-4302 - Phone
- (352) 518-2000
- Fax
- (352) 567-0218
- NPI assigned
- Apr 7, 2006
- Last updated
- Oct 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP3198092 | FL | Primary |
Addresses
Primary practice location
14027 5TH St
Dade City, FL 33525-4302
Mailing address
PO Box 232
Dade City, FL 33526
Phone (352) 518-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3021360000 | Medicaid | FL |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Community Healthcare Group, Inc. | Current | Accepting new patients | |
| Premier Community Healthcare Group Inc | Current | Accepting new patients |
Locations
14027 5th St
Dade City, FL 33525
Phone (813) 782-6064
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Dade City, FL
- NPI 1841263399
-
- Federally Qualified Health Center (FQHC)
- Zephyrhills, FL
- NPI 1508445362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319155200000",
"number": "1710940333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 232",
"city": "DADE CITY",
"state": "FL",
"postal_code": "33526",
"telephone_number": "352-518-2000",
"fax_number": "352-567-5193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14027 5TH ST",
"city": "DADE CITY",
"state": "FL",
"postal_code": "335254302",
"telephone_number": "352-518-2000",
"fax_number": "352-567-0218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "LOUANN",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-07",
"last_updated": "2011-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP3198092",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3021360000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dade City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.