Catherine E Clark, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

162502 Issued in CO

Practice address

1701 W 72ND Ave
Denver, CO 80221-2721

Phone

(303) 650-4460

NPI assigned

Oct 17, 2006

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 identifiers 1

Other names 1

• Catherine J Edstrom Former name

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinica Campesina Family Health ServicesGroup PAC ID 7315850484, 95 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: catherine.clark.p4@direct.clinicafamilyhealth.nextgenshare.com

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.

• Clinica Campesina Family Health Services

  dba Clinica Family Health

  • Clinic/Center
  • Lafayette, CO
  • NPI 1225025406
  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  CO

  Medicare reassignment NPD
• Clinica Campesina Family Health Services

  dba Clinica Family Health and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longmont, CO
  • NPI 1558109223
  NPD
• Clinica Campesina Family Health Services

  dba Clinica Campesina - Thornton

  • Federally Qualified Health Center (FQHC)
  • Thornton, CO
  • NPI 1093702177
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1861573156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 S PUBLIC RD STE 203",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267093",
            "telephone_number": "303-665-3036",
            "fax_number": "303-665-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W 72ND AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802212721",
            "telephone_number": "303-650-4460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7887 E Belleview",
            "address_2": "Suite 1100",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "CO",
            "postal_code": "801116015",
            "country_code": "US",
            "telephone_number": "303-770-0507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CATHERINE",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "162502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79958061",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "catherine.clark.p4@direct.clinicafamilyhealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "NextGen EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "1701 W 72nd Ave",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802212721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "EDSTROM",
            "middle_name": "J",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amber M Clark, RDH
• Amy Leigh Clark, LCSW
• Anne Clark
• Caitlin Clark, MD
• Carly Clark, RDH
• Cheryl Ann Clark, M.D.
• Corine Clark, PMHNP-BC
• Cynthia Clark, MS OTR BCP
• Elisa Ann Clark, LPC
• Elizabeth Clark

• Family Nurse Practitioner in Denver, CO
• Providers in Denver, 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 May 14, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.