Active NPI
Lindsey Ann Clark, FNP-C
- Nurse Practitioner
- Cheyenne, WY
National Provider Identifier
1881174373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 39851.1775
- Practice address
- 2360 E Pershing Blvd
Cheyenne, WY 82001-5356 - Phone
- (307) 778-7550
- NPI assigned
- Aug 15, 2018
- Last updated
- Aug 15, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 39851.1775 | WY | Primary |
Addresses
Primary practice location
2360 E Pershing Blvd
Cheyenne, WY 82001-5356
Mailing address
8715 Red Fox Rd
Cheyenne, WY 82009-1411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200622000752 | WY | Order and Referring Only - Nurse Practitioner | 0547682569 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39851.1775 | WY | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1881174373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8715 RED FOX RD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820091411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2360 E PERSHING BLVD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820015356",
"telephone_number": "307-778-7550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "LINDSEY",
"middle_name": "ANN",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-15",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WY",
"license": "39851.1775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.