Rose M Clark, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

24387 Issued in WV

Practice address

489 Washington Ave
Clarksburg, WV 26301-2825

Phone

(304) 622-2708

Fax

(304) 623-9302

NPI assigned

Dec 11, 2007

Last updated

Mar 30, 2010By 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 names 1

• Ms. Rose Clark Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Health Access Inc

  • Clinic Pharmacy
  • Clarksburg, WV
  • NPI 1568723179
  NPD (past)
• Health Access, Inc.

  • Health Service Clinic/Center
  • Clarksburg, WV
  • NPI 1346458023
  NPD (past)

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1821271008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 WASHINGTON AVE",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012825",
            "telephone_number": "304-622-2708",
            "fax_number": "304-623-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 WASHINGTON AVE",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012825",
            "telephone_number": "304-622-2708",
            "fax_number": "304-623-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROSE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WV",
            "license": "24387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "CLARK",
            "prefix": "MS.",
            "credential": "CFNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karyn Christopher
• Karisa Noelle Chucci
• Angela Churchill, PERSONAL ATTENDANT
• CJS Enterprises, Inc. (Tuscan Sun Spa & Salon)
• CJS Enterprises, Inc. (Tuscan Sun Spa & Salon)
• Clarksburg Audiology and Hearing Aid Center LLC
• Clarksburg Center LLC (Stonerise Clarksburg)
• Clarksburg Nursing & Rehabilitation Center LLC
• Clarksburg SNF LLC (Clarksburg Rehabilitation & Healthcare Center)
• Clarksburg Treatment Center, LLC

• Adult Health Nurse Practitioner in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Adult Health Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.