Cara Clark, NURSE PRACTITIONER

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

AP136560 Issued in TX

Practice address

1500 S Main St
Fort Worth, TX 76104

Phone

(817) 702-1166

NPI assigned

Jun 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Capital Medical Center Specialty Physicians, LLC

  • Occupational Medicine Physician
  • Olympia, WA
  • NPI 1760785281
  NPD
• Seattle Children'S Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  NPD
• Seattle Childrens Hospital

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1992731921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MAGNOLIA AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047657",
            "telephone_number": "817-702-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-702-1166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "76104",
            "country_code": "US",
            "telephone_number": "817-702-1166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 Martin Luther King Jr Way",
            "address_2": "MS Z0-NTL",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054234",
            "country_code": "US",
            "telephone_number": "253-403-1019",
            "fax_number": "253-403-1686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CARA",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WA",
            "license": "AP30005548",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "AP136560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarity Mind and Integrative Wellness PLLC
• Destiny L Clark Williams, LMSW
• Abbie Leann Clark
• Amy Clark, MPT
• Ashley Renee Clark
• Cary Leonard Clark Sr., PHD
• Catherine M. Clark, PH.D.
• Christian Steven Clark, CRNA
• Constance M Clark, SLP
• Cristal R Clark, LPC

• Neonatal Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Neonatal Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.