Individual provider Active NPI

Christina Anna Clarke, LCSW

  • Clinical Social Worker
  • Teecnospos, AZ
National Provider Identifier
1992937494
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC18255 Issued in ME
Practice address
US Hwy 160 & Navajo Route 35
Teecnospos, AZ 86514
Phone
(928) 656-5000
NPI assigned
Aug 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC18255 ME Primary

Addresses

Primary practice location

US Hwy 160 & Navajo Route 35
Teecnospos, AZ 86514

Mailing address

HC 61 Box 30
Teec Nos Pos, AZ 86514-9600
Phone (928) 656-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230128000054 TX Practitioner - Clinical Social Worker 6507237609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

US Hwy 160 and Navajo Route 35-Red Mesa
Teecnospos, AZ 86514
Phone (928) 656-5165

Hospital & facility affiliations

  • Northern Navajo Medical Center Hospital, Shiprock, NM, CCN 320059

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC18255MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital Current Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jan 17, 2023 Accepting new patients
Frontier Health Past Accepting new patients
DHHS PHS Naihs Shiprock Hospital PastSince Jan 29, 2023 Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1992937494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 61 BOX 30",
            "city": "TEEC NOS POS",
            "state": "AZ",
            "postal_code": "865149600",
            "telephone_number": "928-656-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 160 & NAVAJO ROUTE 35",
            "city": "TEECNOSPOS",
            "state": "AZ",
            "postal_code": "86514",
            "telephone_number": "928-656-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "CHRISTINA",
        "middle_name": "ANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC18255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teecnospos, AZ

Sources for this page

Verify at the official NPI Registry.