Individual provider Active NPI

Terri Jo Clark, NP

  • Family Nurse Practitioner
  • Vidor, TX
National Provider Identifier
1770035966
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP132041 Issued in TX
Practice address
2353 N Main St
Vidor, TX 77662-2610
Phone
(409) 813-1677
NPI assigned
Nov 4, 2016
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP132041 TX Primary

Addresses

Primary practice location

2353 N Main St
Vidor, TX 77662-2610

Mailing address

288 Country Lane Dr
Lumberton, TX 77657-6804
Phone (409) 813-1677

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170126000046 TX Practitioner - Nurse Practitioner 8527340637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beaumont Urgent Care Setx LLCGroup PAC ID 1153659040, 6 clinicians

Practice addresses (Care Compare)

3650 N Major Dr
Suite a
Beaumont, TX 77713-9684
Phone (409) 333-1272

Merit-based Incentive Payment System (MIPS)

Final score
79.54 of 100Reported as group
Quality
72.94
Improvement activities
40
Cost
48.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP132041TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Services of Houston and Associates I, PLLC Family CurrentSince Mar 23, 2020 Accepting new patients
Med Management Associates CurrentSince Oct 7, 2024 Accepting new patients
Beaumont Urgent Care Setx, LLC CurrentSince Sep 2, 2025 Accepting new patients

Locations

1175 Denton St
Beaumont, TX 77707
Phone (409) 842-3120

3650 N Major Dr
Ste A
Beaumont, TX 77713
Phone (409) 333-1272

795 Lindbergh Dr
Beaumont, TX 77707
Phone (409) 840-4618

4400 Gulf Ave
Groves, TX 77619
Phone (409) 962-5785

4635 Southwest Fwy
Ste 635
Houston, TX 77027
Phone (214) 923-7777

413 Garland Dr
Lake Jackson, TX 77566
Phone (979) 297-3266

4006 Vista Rd
Pasadena, TX 77504
Phone (713) 943-1592

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

408 Highway 96 S
Silsbee, TX 77656
Phone (409) 373-6415

920 E Avenue L
Silsbee, TX 77656
Phone (409) 385-5571

6602 Memorial Dr
Texas City, TX 77591
Phone (409) 935-2451

470 Moore Dr
Vidor, TX 77662
Phone (409) 749-2454

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1770035966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 COUNTRY LANE DR",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776576804",
            "telephone_number": "409-813-1677",
            "fax_number": "409-813-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2353 N MAIN ST",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776622610",
            "telephone_number": "409-813-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TERRI",
        "middle_name": "JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-04",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidor, TX

Sources for this page

Verify at the official NPI Registry.