Stephanie Irene Clark

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN185331 Issued in GA

Practice address

415 N Jackson St
Americus, GA 31709-3015

Phone

(229) 931-2470

NPI assigned

Jul 6, 2015

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

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.

• Middle Flint Area Community Service Board

  • Public Health or Welfare Agency
  • Americus, GA
  • NPI 1093784720
  NPD (past)
• Middle Flint Community Service Board

  • Community/Behavioral Health Agency
  • Cordele, GA
  • NPI 1700054426
  NPD (past)
• Middle Flint Community Service Board

  • Community/Behavioral Health Agency
  • Cordele, GA
  • NPI 1982872172
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436140800000",
    "number": "1972986206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 TY TY SPARKS RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317936342",
            "telephone_number": "229-942-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N JACKSON ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093015",
            "telephone_number": "229-931-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STEPHANIE",
        "middle_name": "IRENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2015-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN185331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Crimmins Caserio, NP-C
• Chandler Morgan Eyeworks,LLC
• Robin Rae Chandler-Morgan, O.D.
• Yueh-Ying Cheng, M.D.
• Madison Hope Christian, MS, RDN, LDN
• Porsche Clayton
• Vanessa Cliatt
• Clinic Drug Store, Inc.
• Clinic Drug Store, Inc.
• Eric N Codner, DC

• All providers in Americus, GA
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.