CHARLENE CLARK FNP
NPI 1144621756
Nurse Practitioner - Family in Mountain Home, ID

Q: What is Charlene Clark's NPI number?

The NPI number for Charlene Clark is 1144621756. It was assigned to this individual provider in the NPPES registry on September 15, 2014.

Q: What is Charlene Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Charlene Clark was last updated on January 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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 September 15, 2014PECOS EnrolledAccepts Medicare Assignment

94.91/100

CMS Quality Rating

120 DESERT SAGE WAY, MOUNTAIN HOME, ID 83647(208) 587-3988(208) 587-3324 Get Directions Write a Review

NPPES record last updated: January 8, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 8, 2025, Sep 24, 2020 (2 updates tracked since 2020).

On this page

About Charlene Clark Fnp NPPES

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

CHARLENE CLARK FNP (NPI 1144621756) is an individual family provider in Mountain Home, Idaho, licensed in Washington (AP61098520) and active in the NPI registry since September 2014. She is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1144621756

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameCHARLENE CLARKCredential: FNP

Location Address120 DESERT SAGE WAYMountain Home, ID 83647-1038

Mailing Address1205 Teton AveCaldwell, ID 83605-2553 · (901) 500-5766

Phone(208) 587-3988

Fax(208) 587-3324

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateSeptember 15, 2014

Last NPPES UpdateJanuary 8, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 8, 2025

✔ NPI 1144621756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in WA · AP61098520✔ Licensed in ID · 73782✔ Licensed in TN · 19070

120 DESERT SAGE WAY, Mountain Home, ID 83647

Open in Google Maps ↗

Other Identifiers 1

Other19070TN · Apn License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Oscar Insurance Company, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Charlene Clark Fnp 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 ID8123240926

PECOS Enrollment IDI20231122001129

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.

Medicare Billing Reassignments

Medicare enrollment records show Charlene Clark reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Glenns Ferry Health Center, Inc.

Same address

Federally Qualified Health Center (FQHC)

120 DESERT SAGE WAY
Mountain Home, ID 83647

Reassigned Medicare billing, Idaho enrollment
21 clinicians in this Medicare group

NPI 1518097047 (208) 587-3988

Apogee Medical Group PC

453 mi

Internal Medicine

2111 EXCHANGE ST
Astoria, OR 97103

Reassigned Medicare billing, Oregon enrollment
70 clinicians in this Medicare group

NPI 1841461803 (503) 338-4093

Hardin Emergency Group LLC

1,563 mi

Emergency Medicine

2006 WAYNE RD
Savannah, TN 38372

Reassigned Medicare billing, Tennessee enrollment
37 clinicians in this Medicare group

NPI 1972850477 (800) 893-9698

Fast Pace Medical Clinic PLLC

1,613 mi

Family Medicine

3813 OLD PORT ROYAL RD N
Spring Hill, TN 37174

Reassigned Medicare billing, Tennessee enrollment
985 clinicians in this Medicare group

NPI 1134452865 (931) 487-1006

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

72 services71 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

54 services51 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

16 services16 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

14 services12 patients

Detection test by nucleic acid for multiple types influenza virus 87502

A detection test by nucleic acid for multiple types of influenza virus is a diagnostic procedure. It identifies the genetic material of the virus in your body. It's highly accurate and can distinguish between different flu strains, helping in prompt and precise treatment.

12 services12 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130006

Location190 East Bannock StreetBoise, ID 83712 · Ada County

Emergency services Birthing friendly

Saint Alphonsus Medical Center - Ontario

Acute Care Hospitals · Ontario, OR

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number380052

Location351 SW 9th StreetOntario, OR 97914 · Malheur County

Emergency services

St. Alphonsus Medical Center - Baker City

Critical Access Hospitals · Baker City, OR

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number381315

Location3325 Pocahontas RoadBaker City, OR 97814 · Baker County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83647 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.91/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

87.83

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier27 claims27 services$18.15 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers51 claims51 services$93.13 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 19

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

DAWN D BEST FNP

Nurse Practitioner (Family)