Melissa Clark, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A174388 Issued in IA

Practice address

3421 W 9TH St
Waterloo, IA 50702-5401

Phone

(319) 272-8200

NPI assigned

Feb 2, 2008

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

Medicare fee-for-service enrollment

Enrolled in IA

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical Center IncGroup PAC ID 0244148732, 234 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone Waterloo Medical Center Hospital, Waterloo, IA, CCN 160067

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mclark3930897@direct.trinity-health.org

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.

• Covenant Medical Center Inc

  dba MercyOne Medical Group Northeast Iowa

  • Family Medicine Physician
  • Waterloo, IA
  • NPI 1548288160

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Covenant Medical Center, Inc.

  dba MercyOne Evansdale home medical equipment

  • Customized Equipment (DME)
  • Evansdale, IA
  • NPI 1851141980
  NPD
• Black Hawk-Grundy Mental Health Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterloo, IA
  • NPI 1316944598
  NPD (past)
• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390
  NPD (past)

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

• Covenant Medical Center Inc

  dba MercyOne Waterloo Medical Center

  • General Acute Care Hospital
  • Waterloo, IA
  • NPI 1700827896
  Care Compare affiliation

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

{
    "created_epoch": "1201910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1902084858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-02",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A174388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074435",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• City of Waterloo (Waterloo Fire Rescue)
• Clark and Associates, Inc
• Grant William Clark
• Jessica Nicole Clark, NP-C
• Kirby P Clark, M.D.
• Christopher Edmund Clayton, PHARMD
• Jennifer Leigh Clayton, PHARMD
• Webster N Clayton, MD
• Kristi M Clements, LISW
• Clinical Pathology Associates, PC

• Nurse Practitioner in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.