Mary Elizabeth Bernal Clark, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R131285 Issued in MD

Practice address

100 E Carroll St
Salisbury, MD 21801-5422

Phone

(410) 543-7536

Fax

(410) 543-7272

NPI assigned

Oct 14, 2005

Last updated

Feb 20, 2015By 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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, DE2 enrollments

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 2

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.

• Vista Medical Services, Inc.

  • Psychiatry Physician
  • Bala Cynwyd, PA
  • NPI 1659452027

  DE

  Medicare reassignment NPD
• Andrea Baier MD

  • Hospitalist Physician
  • Berlin, MD
  • NPI 1427181593
  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1760471684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-543-7536",
            "fax_number": "410-543-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-543-7536",
            "fax_number": "410-543-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL CLARK",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R131285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405537300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regan Benton
• Julian Berard
• David Berendt
• Nicole Renee Bergstrom, OTR
• Katie Berna, FNP-C
• Bernard J Dormer DDS PA
• Avraham Bernstein
• Shon'Ta Berry
• Salman Zahoor Bhat, MBBS,MD
• Shraddha Bhattarai

• Nurse Practitioner in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.