NPIMap

Individual provider Active NPI

Jenkins Lucas Clarkson, MD

  • Obstetrics & Gynecology Physician
  • Powell, WY
National Provider Identifier
1861500654
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
9432A Issued in WY
Practice address
450 Mountain View
Powell Valley Healthcare
Powell, WY 82435
Phone
(307) 754-7257
Fax
(307) 754-1226
NPI assigned
Aug 29, 2006
Last updated
Mar 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD25997 OR
Obstetrics & Gynecology Physician 207V00000X 98-00815 NC
Obstetrics & Gynecology Physician 207V00000X 9432A WY Primary

Addresses

Primary practice location

450 Mountain View
Powell Valley Healthcare
Powell, WY 82435

Mailing address

777 Ave H
Powell Valley Healthcare
Powell, WY 82435
Phone (307) 754-7257

Other identifiers 1

IdentifierTypeStateIssuer
8911641MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20131003000425 WY Practitioner - Obstetrics/Gynecology 5294779351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical University of South Carolina College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powell Valley Healthcare IncGroup PAC ID 5092798561, shared by 5 NPIs, 31 clinicians

Practice addresses (Care Compare)

450 Mountain View
Powell, WY 82435-2212
Phone (307) 754-7257

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.54 of 100Reported as group
Quality
71.68
Promoting interoperability
100
Improvement activities
40
Cost
70.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
98-00815NCMDObstetrics & Gynecology Physician
MD25997ORMDObstetrics & Gynecology Physician
9432AWYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Powell Valley Health Care Inc CurrentSince Aug 19, 2013 Accepting new patients
Powell Valley Healthcare Inc Obstetrics & Gynecology CurrentSince Aug 19, 2013 Accepting new patients

Locations

450 Mountain View St
Powell, WY 82435
Phone (307) 754-2267

450 Mountain View St
Bldg C
Powell, WY 82435
Phone (307) 254-0661

777 Avenue H
Powell, WY 82435
Phone (307) 754-1175

Interoperability endpoints

  • Direct secure messaging: jclarkson@powellvalleyhealthcare.cernerdirect.com

Organizations & group practices 2

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 9

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1861500654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 AVE H",
            "address_2": "POWELL VALLEY HEALTHCARE",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "82435",
            "telephone_number": "307-754-7257",
            "fax_number": "307-754-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 MOUNTAIN VIEW",
            "address_2": "POWELL VALLEY HEALTHCARE",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "82435",
            "telephone_number": "307-754-7257",
            "fax_number": "307-754-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKSON",
        "first_name": "JENKINS",
        "middle_name": "LUCAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD25997",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "98-00815",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WY",
            "license": "9432A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911641",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, WY

Sources for this page

Verify at the official NPI Registry.