TABITHA RYNN CLARK CNP
NPI 1124762695
Nurse Practitioner - Primary Care in Arthurdale, WV
About Tabitha Rynn Clark Cnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TABITHA RYNN CLARK CNP (NPI 1124762695) is an individual primary care provider in Arthurdale, West Virginia, licensed in West Virginia (112519) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tabitha Rynn Clark Cnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 26520 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ARTHURDALE, WV 26520
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tabitha Clark's NPI number?
The NPI number for Tabitha Clark is 1124762695. It was assigned to this individual provider in the NPPES registry on April 21, 2022. The provider is also known as Tabitha Rynn Jeffries.
Where is Tabitha Clark located?
Tabitha Clark practices at 519 G Road, Arthurdale, WV 26520. The listed phone number is (304) 864-0884.
What is Tabitha Clark's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Tabitha Clark enrolled in Medicare?
Yes. Tabitha Clark is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Tabitha Clark was last updated on September 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Tabitha Rynn Clark, CNP · NPI 1124762695
Primary Care physician in Arthurdale, West Virginia. Individual provider, active in the CMS NPPES registry since April 21, 2022.
## Identity
- **NPI:** 1124762695 (Entity type: Individual)
- **Enumerated:** April 21, 2022
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** 112519 (West Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 519 G ROAD, Arthurdale, WV 26520
- **Phone:** (304) 864-0884
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** September 29, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1124762695) · Data from the CMS NPPES public registry.