Rachel L Clark, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA.1193-NP Issued in OH

Practice address

110 Ho PLZ
Ithaca, NY 14853-3102

Phone

(607) 255-5155

NPI assigned

Dec 3, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Cornell University

  • Student Health Clinic/Center
  • Ithaca, NY
  • NPI 1073584926
  NPD (past)

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1740518646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HO PLZ",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148533102",
            "telephone_number": "607-255-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HO PLZ",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148533102",
            "telephone_number": "607-255-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RACHEL",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-03",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337544",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.1193-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE PRACTITIONER",
            "identifier": "COA.11193-NP",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "RN.355902-COA1",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Catherine Clapp, NP
• Clare Joanne Nicholetti, LCSW
• Jessica Carolyn Clark Manderville, RN
• Debra E Clark, PH.D.
• Mitzi D Clark, DVM
• William Ray Clark Jr., PHARM D
• Lisa Marie Clauson, FNP
• Judith Ellen Clay, M.S.W
• Clearview Psychotherapy Associates
• Matthew John Clements, PT, DPT

• Family Nurse Practitioner in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.