Calvin Clark, RN, MSN, ACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

743836 Issued in TX

Practice address

808 Joliet Ave Unit 220
Lubbock, TX 79415-1158

Phone

(806) 761-0566

Fax

(806) 744-7252

NPI assigned

Nov 13, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Umc Physicians

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1669418547

  NM

  Medicare reassignment

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

{
    "created_epoch": "1289606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1811298458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 CITY BANK PKWY STE 35",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794073545",
            "telephone_number": "806-761-0333",
            "fax_number": "806-785-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 JOLIET AVE UNIT 220",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794151158",
            "telephone_number": "806-761-0566",
            "fax_number": "806-744-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CALVIN",
        "name_prefix": "Mr.",
        "credential": "RN, MSN, ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-13",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "743836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Breanne Clair
• Chase Clanton
• Landry David Clapp, DDS
• Angelea Michele Clarida, LVN
• Alicia Clark, MDT
• Courtney Shay Clark, PTA
• Justin Wayne Clark, MD
• Nathan R Clark, MD
• Sara B Clark, M.S., CCC-SLP
• Shawn Clark

• Acute Care Nurse Practitioner in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.