Cynthia Dawn Clark, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

22984 Issued in TN

Practice address

1420 N Gateway Ave
Rockwood, TN 37854

Phone

(865) 354-7799

NPI assigned

Aug 28, 2017

Last updated

Jun 23, 2020By the provider in NPPES

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 names 1

• Cyndi Dawn Ainsworth Other name

Medicare fee-for-service enrollment

Enrolled in TN

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Putnam Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Cookeville, TN
  • NPI 1891475752
  Medicare reassignment NPD
• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment NPD
• Summit Medical Group, PLLC

  dba Rockwood Medical Associates

  • Internal Medicine Physician
  • Rockwood, TN
  • NPI 1568772754
  NPD

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1750808093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N GATEWAY AVE",
            "city": "ROCKWOOD",
            "state": "TN",
            "postal_code": "378544111",
            "telephone_number": "865-354-7799",
            "fax_number": "865-354-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N GATEWAY AVE",
            "city": "ROCKWOOD",
            "state": "TN",
            "postal_code": "37854",
            "telephone_number": "865-354-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CYNTHIA",
        "middle_name": "DAWN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "22984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNDI",
            "last_name": "AINSWORTH",
            "middle_name": "DAWN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jerame A Brown, DDS
• Patrick Timothy Brown
• Lora Casasfranco, OTR/L, CLT
• Darrell Eugene Cates Jr., DDS
• Courtney Leigh Chrestman
• Jessica Ruth Anne Cook, PHARMD
• Charles Joseph Corea, MD
• Travis A Crabtree, TN CNA KY CNA
• Linda Crawford
• Teresa D Crudup, CNA

• Nurse Practitioner in Rockwood, TN
• Providers in Rockwood, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.

Verify at the official NPI Registry.