TRI-LAKES FAMILY CARE
NPI 1134500739
Nurse Practitioner - Family in Branson, MO
About Tri-lakes Family Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRI-LAKES FAMILY CARE (NPI 1134500739) is a healthcare organization registered as a family in Branson, Missouri and active in the NPI registry since June 2015. The organization holds a CLIA Waiver certificate valid through October 6, 2027 and lists Carolyn Clark, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tri-lakes Family Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Tri-Lakes Family Care, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 26D2103211
Tri-Lakes Family Care · Branson, MOFrequently 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 Carolyn Clark Fnp LLC's NPI number?
The NPI number for Carolyn Clark Fnp LLC is 1134500739. It was assigned to this organization in the NPPES registry on June 9, 2015. The provider is doing business as Tri-Lakes Family Care.
Where is Carolyn Clark Fnp LLC located?
Carolyn Clark Fnp LLC is located at 1232 Branson Hills Pkwy Ste 106, Branson, MO 65616. The listed phone number is (417) 332-3639.
What is Carolyn Clark Fnp LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Carolyn Clark Fnp LLC enrolled in Medicare?
Yes. Carolyn Clark Fnp LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Carolyn Clark Fnp LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Carolyn Clark Fnp LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3) and Emergency Medicine (1). Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Carolyn Clark Fnp LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 26D2103211) is associated with this NPI, valid through October 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Carolyn Clark Fnp LLC accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Carolyn Clark Fnp LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Carolyn Clark Fnp LLC was last updated on June 9, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Tri-Lakes Family Care · NPI 1134500739
Family organization in Branson, Missouri. Organization record, active in the CMS NPPES registry since June 9, 2015.
## Identity
- **NPI:** 1134500739 (Entity type: Organization)
- **Enumerated:** June 9, 2015
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Legal business name:** Carolyn Clark Fnp Llc
- **Organization subpart:** No
- **Authorized official:** Carolyn Clark, OWNER
## Practice location
- **Address:** 1232 BRANSON HILLS PKWY STE 106, Branson, MO 65616-4189
- **Phone:** (417) 332-3639 · **Fax:** (417) 332-3641
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Emergency Medicine (1); 3 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 9, 2015
- **Other identifiers:** Other 1679915664 (MO)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1134500739) · Data from the CMS NPPES public registry.