JEANETTE MARIE CLARK APRN - NPI 1265315154 - Nurse Practitioner in Phoenix, AZ

Q: What is Jeanette Clark's NPI number?

The NPI number for Jeanette Clark is 1265315154. It was assigned to this individual provider in the NPPES registry on July 28, 2025.

Q: What is Jeanette Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Jeanette Clark was last updated on February 17, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Jeanette Marie Clark Aprn NPPES

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

JEANETTE MARIE CLARK APRN (NPI 1265315154) is an individual adult health provider in Phoenix, Arizona, licensed in Arizona (334234) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1265315154

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameJEANETTE MARIE CLARKCredential: APRN

Location Address3811 E BELL RD STE 111Phoenix, AZ 85032-2158

Mailing Address24611 N 144th AveSurprise, AZ 85387-7033 · (208) 270-2178

Phone(208) 270-2178

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJuly 28, 2025

Last NPPES UpdateFebruary 17, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 17, 2026

✔ NPI 1265315154 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in AZ · 334234

3811 E BELL RD STE 111, Phoenix, AZ 85032

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeanette Marie Clark Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951884535

PECOS Enrollment IDI20260311003821

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85032 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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 7

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

PAIN AND PALLIATIVE ASSOCIATES OF ARIZONA

Pain Medicine (Pain Medicine)