Takela Smith-Clark

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1033007 Issued in TX

Practice address

2918 Dogwood Blossom TRL
Pearland, TX 77581-5035

Phone

(832) 633-7962

NPI assigned

May 7, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Med Management AssociatesGroup PAC ID 7810299187, 35 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.54 of 100Reported as group

Quality

72.94

Improvement activities

40

Cost

48.08

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Med Management Associates

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1508233040
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1740864610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 DOGWOOD BLOSSOM TRL",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815035",
            "telephone_number": "832-633-7962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 DOGWOOD BLOSSOM TRL",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815035",
            "telephone_number": "832-633-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-CLARK",
        "first_name": "TAKELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1033007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BON LICENSE",
            "identifier": "1033007",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pearland",
            "affiliation": "N",
            "address_1": "2918 Dogwood Blossom Trl",
            "city": "Pearland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775815035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sler Specialists PLLC
• Randa Sloan
• Kristen Slone, MSOT, OTR, CHT, CWT
• Smart Body Chiropractic & Wellness, P.C.
• Smile Dental PLLC
• Dorothy B Smith-Hubbard, DOCTOR
• Aisha Nichole Smith-Shoemo, LPC-A
• Alysia Smith
• Bailee Smith, M.ED., BCBA
• Bernadette Pearline Smith, EDD., LPC-S

• Psychiatric/Mental Health Nurse Practitioner in Pearland, TX
• Providers in Pearland, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.