Taylor Ellis Clark, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

27071 Issued in SC

Practice address

10 Enterprise Blvd Ste 45
Greenville, SC 29615-6301

Phone

(864) 295-6399

NPI assigned

Feb 15, 2023

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

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20694/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/20461/brand/1/csg/21/fhir/r4
• Direct secure messaging: taylor.clark.1@20694.direct.athenahealth.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.

• Carolinas Center for Advanced Management of Pain, LLC

  • Interventional Pain Medicine Physician
  • Spartanburg, SC
  • NPI 1750304002
  Medicare reassignment NPD
• Carolinas Center for Advanced Management of Pain

  • Interventional Pain Medicine Physician
  • Gastonia, NC
  • NPI 1578968079
  NPD
• Elle OBGYN LLC

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1073029278
  NPD (past)

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1952008351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 DUKE ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054423",
            "telephone_number": "864-270-6327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ENTERPRISE BLVD STE 45",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156301",
            "telephone_number": "864-295-6399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "279 E Kennedy St",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293021912",
            "country_code": "US",
            "telephone_number": "864-583-0053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TAYLOR",
        "middle_name": "ELLIS",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SC",
            "license": "27071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kathlyn Clark, FNP
• Matthew Thomas Clark, M.D.
• Russell Derrick Clark, DPT
• Sara Morgan Clark, M.D.
• Susan Nock Clark, RN
• Thomas Monroe Clark, DDS
• William Leroy Clark, MD
• Christopher Khalil Clarke
• Crystal Clarke
• Dayna Clarke, RN, CNA

• Primary Care Nurse Practitioner in Greenville, SC
• Providers in Greenville, SC by specialty
• Primary Care Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.