Active NPI
Doris Elizabeth Clark, CRNP
- Nurse Practitioner
- Huntsville, AL
National Provider Identifier
1740549559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1-051144
- Practice address
- 813 Franklin Street
Huntsville, AL 35801-4311 - Phone
- (256) 519-3650
- Fax
- (256) 585-6713
- NPI assigned
- May 14, 2012
- 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 | 1-051144 | AL | Primary |
Addresses
Primary practice location
813 Franklin Street
Huntsville, AL 35801-4311
Mailing address
813 Franklin Street
Huntsville, AL 35801-4311
Phone (256) 519-3650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-051144 | AL | MD | Nurse Practitioner |
Interoperability endpoints
- declark@hi-al.direct.office.nextgen.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336953600000",
"number": "1740549559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813 FRANKLIN STREET",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358014311",
"telephone_number": "256-519-3650",
"fax_number": "256-585-6713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 FRANKLIN STREET",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358014311",
"telephone_number": "256-519-3650",
"fax_number": "256-585-6713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DORIS",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-14",
"last_updated": "2012-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "1-051144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.