Linda Marie Clark, RN

Primary specialty

Gerontology Registered NurseTaxonomy code 163WG0600X

License

26NR13150400 Issued in NJ

Practice address

56 Sharon CT
Metuchen, NJ 08840-1730

Phone

(732) 734-7406

Fax

(732) 452-4133

NPI assigned

Feb 22, 2022

Last updated

Feb 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

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": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1801542592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 SHARON CT",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088401730",
            "telephone_number": "732-734-7406",
            "fax_number": "732-452-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 SHARON CT",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088401730",
            "telephone_number": "732-734-7406",
            "fax_number": "732-452-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LINDA",
        "middle_name": "MARIE",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "NJ",
            "license": "26NR13150400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Linda.Clark@dmava.nj.gov",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Work",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "work",
            "address_1": "132 Evergreen Rd",
            "city": "Edison",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "088372484",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Linda.Clark@dmava.nj.gov",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Work",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "work",
            "address_1": "132 Evergreen Rd",
            "city": "Edison",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "088372484",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Linda.Clark@dmava.nj.gov",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Work",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "work",
            "address_1": "132 Evergreen Rd",
            "city": "Edison",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "088372484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Gerontology Registered Nurse in Metuchen, NJ
• Providers in Metuchen, NJ by specialty
• Gerontology Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.