Karen Clark, R.N.

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

RN9232718 Issued in FL

Practice address

120 International Pkwy
Suite 220
Lake Mary, FL 32746-5031

Phone

(800) 432-8421

Fax

(407) 333-8928

NPI assigned

Aug 25, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1780051847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 952679",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327952679",
            "telephone_number": "800-432-8421",
            "fax_number": "407-333-8928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 INTERNATIONAL PKWY",
            "address_2": "SUITE 220",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465031",
            "telephone_number": "800-432-8421",
            "fax_number": "407-333-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KAREN",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "FL",
            "license": "RN9232718",
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "IN",
            "license": "28066933A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jonathan Paul Clarke, M.D.
• Classic Dental, Inc.

• Point of Service in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Point of Service in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.