Jeremy James Clark

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.022794 Issued in OH

Practice address

1900 S Main St
Findlay, OH 45840

Phone

(419) 423-4500

Fax

(419) 423-5358

NPI assigned

May 21, 2018

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 OH

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialty Physicians of Blanchard Valley LLCGroup PAC ID 2668547613, 117 clinicians

Blanchard Valley Medical Associates, IncGroup PAC ID 5698763589, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blanchard Valley Hospital Hospital, Findlay, OH, CCN 360095
• Bluffton Hospital Hospital, Bluffton, OH, CCN 361322
• Fostoria Community Hospital Hospital, Fostoria, OH, CCN 361318

Merit-based Incentive Payment System (MIPS)

Final score

79.59 of 100Reported as group

Quality

57.93

Promoting interoperability

97

Improvement activities

40

Cost

76.55

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeremy.clark@bvma.gwaydirect.com
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1689

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.

• Blanchard Valley Medical Associates, Inc.

  • Internal Medicine Physician
  • Findlay, OH
  • NPI 1407814775
  Medicare reassignment Care Compare group NPD
• Specialty Physicians of Blanchard Valley LLC

  • Cardiovascular Disease Physician
  • Findlay, OH
  • NPI 1689835415
  Medicare reassignment Care Compare group NPD
• Blanchard Valley Medical Associates, Inc

  • Clinical Medical Laboratory
  • Findlay, OH
  • NPI 1073716312
  NPD
• Blanchard Valley Regional Health Center

  • Family Medicine Physician
  • Findlay, OH
  • NPI 1083665251
  NPD
• Blanchard Valley Regional Health Center

  • Rehabilitation Hospital Unit
  • Findlay, OH
  • NPI 1578336400
  NPD
• Blanchard Valley Regional Health Center

  • Emergency Medicine Physician
  • Findlay, OH
  • NPI 1699718320
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Blanchard Valley Regional Health Center

  • General Acute Care Hospital
  • Findlay, OH
  • NPI 1710920327
  Care Compare affiliation
• Blanchard Valley Regional Health Center

  • Critical Access Hospital
  • Bluffton, OH
  • NPI 1831137827
  Care Compare affiliation
• Fostoria Hospital Association

  • Critical Access Hospital
  • Fostoria, OH
  • NPI 1275533226
  Care Compare affiliation

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1912498338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20378 STATE ROUTE 18",
            "city": "CUSTAR",
            "state": "OH",
            "postal_code": "435119760",
            "telephone_number": "419-889-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S MAIN ST",
            "city": "FINDLAY",
            "state": "OH",
            "postal_code": "45840",
            "telephone_number": "419-423-4500",
            "fax_number": "419-423-5358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JEREMY",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.022794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Dawn Chukes, CDCA
• City of Findlay
• Marrissa Jade Claburn
• Casey Kay Clark, PA-C
• Erin Colleen Clark, FNP
• Lindsey Leigh Clark, FNP
• Kelly Cleveland
• Danielle Clevenger, RN
• Clinger Chiropractic Center, LLC
• David A. Clinger, LMT, NCMMT, LLCC

• Family Nurse Practitioner in Findlay, OH
• Providers in Findlay, OH by specialty
• Family Nurse Practitioner in Ohio

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