Active NPI
Mikaila Ann Turner Clarke, NP
- Adult Health Nurse Practitioner
- Worcester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- RN2275336
- Practice address
- 100 Grove St Ste 115
Worcester, MA 01605-2630 - Phone
- (833) 904-0620
- NPI assigned
- Jan 25, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5553 | MA | |
| Registered Nurse | 163W00000X | RN2275336 | MA | |
| Adult Health Nurse Practitioner | 363LA2200X | RN2275336 | MA | Primary |
Addresses
Primary practice location
100 Grove St Ste 115
Worcester, MA 01605-2630
Mailing address
100 Grove St Ste 115
Worcester, MA 01605-2630
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1302604 | Medicaid | MA | |
| 1301071 | Other | MA | GROUP MEDICAID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5553 | MA | MD | Mental Health Counselor |
| RN2275336 | MA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cityblock Medical Practice, P.a. | Current | Accepting new patients |
Locations
155 Federal St
Ste 700
Boston, MA 02110
Phone (469) 466-7420
100 Grove St
Ste 115
Worcester, MA 01605
Phone (347) 463-5529
495 Flatbush Ave
Brooklyn, NY 11225
Phone 80033611001
55 Water St
#4C
Brooklyn, NY 11201
Phone (917) 718-2063
495 Flatbush Ave
Ste C5
Brooklyn, NY 11225
Phone (215) 588-1676
Interoperability endpoints
- mikaila.turner-.clarke.1@27775.direct.athenahealth.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684281600000",
"number": "1740336882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 GROVE ST STE 115",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 GROVE ST STE 115",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052630",
"telephone_number": "833-904-0620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TURNER CLARKE",
"first_name": "MIKAILA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2023-05-17",
"certification_date": "2023-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "5553",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "RN2275336",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MA",
"license": "RN2275336",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1302604",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICAID NUMBER",
"identifier": "1301071",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.