Jennifer Clark, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R210538 Issued in MD

Practice address

11110 Medical Campus Rd Ste 205
Hagerstown, MD 21742-6797

Phone

(301) 665-4950

Fax

(301) 665-4956

NPI assigned

Jul 21, 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 MD

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

Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Medical Practices of Antietam, LLCGroup PAC ID 2567353865, 229 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Meritus Medical Center, Inc Home health agency, Hagerstown, MD, CCN 217085
• Meritus Medical Center Hospital, Hagerstown, MD, CCN 210001

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 and National Provider Directory roles.

• Medical Practices of Antietam LLC

  • Clinic/Center
  • Hagerstown, MD
  • NPI 1710854963
  Medicare reassignment Care Compare group NPD
• Medical Practices of Antietam, LLC

  • General Practice Physician
  • Hagerstown, MD
  • NPI 1558430843
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Meritus Medical Center Inc

  • General Acute Care Hospital
  • Hagerstown, MD
  • NPI 1942281266
  Care Compare affiliation
• Meritus Medical Center, Inc.

  • Home Health Agency
  • Hagerstown, MD
  • NPI 1942290077
  Care Compare affiliation

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1962182238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 205",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426797",
            "telephone_number": "301-665-4950",
            "fax_number": "301-665-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 205",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426797",
            "telephone_number": "301-665-4950",
            "fax_number": "301-665-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R210538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis J Citro Jr., M.D.
• CJ'S Senior Care, Inc.
• Angelica Clark
• Christopher David Clark, M.D.
• Jennifer Clark, PTA
• Mildred Clark
• Nicole Clark
• Alishia Clarke
• Douglas Dixon Clarke, D.O.
• Martha Clausman

• Family Nurse Practitioner in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.