NPIMap

Individual provider Active NPI

Lauren D'Ann Clark, NP

  • Adult Health Nurse Practitioner
  • Edmond, OK
National Provider Identifier
1821627167
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R0100056 Issued in OK
Practice address
105 S Bryant Ave Ste 101
Edmond, OK 73034-6330
Phone
(405) 823-0094
NPI assigned
Apr 8, 2020
Last updated
Dec 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R0100056 OK Primary

Addresses

Primary practice location

105 S Bryant Ave Ste 101
Edmond, OK 73034-6330

Mailing address

3305 Red Maple LN
Moore, OK 73170-1025
Phone (405) 823-0094

Other practice location 1

3525 NW 56th St
Oklahoma City, OK 73112-4550
Phone (405) 761-3199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630003044 OK Practitioner - Nurse Practitioner 2668895178 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crescent Post Acute Care PLLCGroup PAC ID 4385022391, 3 clinicians
Crescent Infectious Diseases PLLCGroup PAC ID 8820222847, 7 clinicians
Allied Wound Care Specialist PLLCGroup PAC ID 5698195360, 11 clinicians

Practice addresses (Care Compare)

1111 N Lee Ave
Suite 249
Oklahoma City, OK 73103-2600
Phone (214) 937-1387

4220 N Classen Blvd
Suite C
Oklahoma City, OK 73118-2416
Phone (405) 900-4995

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0100056OKMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Wellness Anadarko Inc CurrentSince May 11, 2024 Accepting new patients
Crescent Infusion Health Clinic PLLC CurrentSince Jul 1, 2024 Accepting new patients
Rural Wellness Fairfax Inc CurrentSince May 11, 2024 Accepting new patients
Crescent Post Acute Care PLLC CurrentSince Jul 1, 2024 Accepting new patients
Allied Wound Care Specialist PLLC CurrentSince Sep 1, 2024 Accepting new patients
Crescent Infectious Diseases PLLC CurrentSince Jul 1, 2024 Accepting new patients
Rural Wellness Anadarko Inc CurrentSince May 11, 2024 Accepting new patients
Spectrum Healthcare Solutions, PLLC CurrentSince Sep 1, 2024 Accepting new patients
Oklahoma Pulmonary and Critical Care PLLC CurrentSince Sep 28, 2022 Accepting new patients
Healwell, LLC Family CurrentSince Nov 10, 2022 Accepting new patients
Rural Wellness Fairfax Inc CurrentSince May 11, 2024 Accepting new patients
Complete & Comprehensive Kidney Care PLLC CurrentSince Jan 20, 2024 Accepting new patients

Locations

1002 E Central Blvd
Anadarko, OK 73005
Phone (405) 247-2551

40 Hospital Rd
Fairfax, OK 74637
Phone (918) 642-8827

1111 N Lee Ave
Ste 249
Oklahoma City, OK 73103
Phone (214) 937-1387

1145 W I 240 Service Rd
Ste F100
Oklahoma City, OK 73139
Phone (405) 898-9048

2801 Parklawn Dr
Ste 302
Oklahoma City, OK 73110
Phone (405) 492-7229

3524 NW 56th St
Oklahoma City, OK 73112
Phone (405) 606-6700

4200 S Douglas Ave
Ste 108
Oklahoma City, OK 73109
Phone (405) 636-7220

4220 N Classen Blvd
Ste A
Oklahoma City, OK 73118
Phone (405) 768-5749

4220 N Classen Blvd
Ste C
Oklahoma City, OK 73118
Phone (405) 900-4995

Dept 960617
Oklahoma City, OK 73196

2308 W Highway 66
Stroud, OK 74079
Phone (918) 968-3571

Organizations & group practices 12

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1821627167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 RED MAPLE LN",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731701025",
            "telephone_number": "405-823-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S BRYANT AVE STE 101",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346330",
            "telephone_number": "405-823-0094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 NW 56th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731124550",
            "country_code": "US",
            "telephone_number": "405-761-3199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LAUREN",
        "middle_name": "D'ANN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-08",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OK",
            "license": "R0100056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.