SHONDA T CLARK NP
NPI 1114308251
Nurse Practitioner in Chicago, IL

Q: What is Shonda Clark's NPI number?

The NPI number for Shonda Clark is 1114308251. It was assigned to this individual provider in the NPPES registry on June 15, 2015.

Q: What is Shonda Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Shonda Clark was last updated on September 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 15, 2015PECOS EnrolledAccepts Medicare Assignment

5841 S MARYLAND AVE, CHICAGO, IL 60637(773) 702-3844 Get Directions Write a Review

NPPES record last updated: September 24, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Shonda T Clark Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHONDA T CLARK NP (NPI 1114308251) is an individual nurse practitioner in Chicago, Illinois, licensed in Illinois (209011572) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with Medical City Plano, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1114308251

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameSHONDA T CLARKCredential: NP

Location Address5841 S MARYLAND AVEChicago, IL 60637-1447

Mailing Address1600 Coit Rd Ste 104Plano, TX 75075-6171 · (972) 566-5411 · Fax (972) 519-8337

Phone(773) 702-3844

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateJune 15, 2015

Last NPPES UpdateSeptember 24, 2021

NPPES CertifiedSeptember 24, 2021

✔ NPI 1114308251 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Licenses✔ Licensed in IL · 209011572✔ Licensed in TX · 1018533

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

5841 S MARYLAND AVE, Chicago, IL 60637

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shonda T Clark Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890003305

PECOS Enrollment IDI20210924001671

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Medical City Plano

Acute Care Hospitals · Plano, TX

3/5 CMS rating

OwnershipProprietary

CMS Certification Number450651

Location3901 W 15th StPlano, TX 75075 · Collin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60637 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DON MARTINEZ M.D.

Radiology (Diagnostic Radiology)