Rd Clare, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

90097 Issued in CO

Practice address

2754 Compass Dr
Ste 170
Grand Junction, CO 81506-8714

Phone

(970) 254-1686

NPI assigned

Mar 12, 2012

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 CO

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

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  CO

  Medicare reassignment NPD
• Western Slope Geriatrics, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Grand Junction, CO
  • NPI 1003186230
  NPD (past)

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1831464650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 O RD",
            "city": "LOMA",
            "state": "CO",
            "postal_code": "815249543",
            "telephone_number": "970-640-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2754 COMPASS DR",
            "address_2": "STE 170",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068714",
            "telephone_number": "970-254-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARE",
        "first_name": "RD",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-12",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "90097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Citadel Security USA
• Robert S Citkovic, PA
• City of Grand Junction
• City of Grand Junction
• Cizar LLC
• Callee Cosby Clark, DDS
• Darrel Christian Clark, DO
• Elizabeth Clark, MA, LPC
• Haley M Clark, PT, DPT
• Jillian Clark

• Family Nurse Practitioner in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; 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.