Dominique Clarke

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11004924 Issued in FL

Practice address

10000 W Sample Rd
Coral Springs, FL 33065-3936

Phone

(954) 798-7114

NPI assigned

Jan 30, 2020

Last updated

Feb 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

At Home Concierge Care LLCGroup PAC ID 3476909805, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Certified Homecare of the Palm Beaches Home health agency, Boca Raton, FL, CCN 108316

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• At Home Concierge Care LLC

  • Nurse Practitioner
  • Boca Raton, FL
  • NPI 1437937877
  Medicare reassignment Care Compare group
• Nursing Home Physicians PA

  dba Glenn Gidseg

  • Internal Medicine Physician
  • Marathon, FL
  • NPI 1396769725

  Family

  Medicare reassignment NPD
• Vitae Health Medical Florida PLLC

  • Internal Medicine Physician
  • Rockledge, FL
  • NPI 1013562024
  Medicare reassignment NPD
• Nursing Home Consultants LLC

  • Internal Medicine Physician
  • Marathon, FL
  • NPI 1033346945
  NPD (past)

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

• Macadams Home Health Agency Inc

  dba Certified Home Care of the Palm Beaches

  • Home Health Agency
  • Boca Raton, FL
  • NPI 1386752822
  Care Compare affiliation

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1932730702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 NW 54TH LN",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333192453",
            "telephone_number": "954-822-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653936",
            "telephone_number": "954-798-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "eclin",
            "affiliation": "N",
            "address_1": "10000 W Sample Rd",
            "city": "Coral Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330653936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Clark
• Niya Clark
• Stacy L Clark, LMT
• Tanaia Clark
• Tamara Clarke Chin, APRN, FNP-BC, FNP-C
• Melissa Georginna Clarke, APRN
• Sibylle Claude, LMT
• Clear Your Mind,LLC
• Mitchnida Clervil, LCSW
• Cleveland Clinic Florida (a Nonprofit Corporation) (Cleveland Clinic Coral Springs Ambulatory Surgery Center)

• Family Nurse Practitioner in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.