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MR. PHILLIP WAYNE CLARK DNP
NPI 1629471412
Nurse Practitioner - Family in Creve Coeur, MO

Active since October 07, 2014PECOS EnrolledAccepts Medicare Assignment
11560 OLIVE BLVD, CREVE COEUR, MO 63141(314) 995-7128(314) 995-7221 Get Directions Write a Review

NPPES record last updated: March 31, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 31, 2026, Mar 17, 2026, May 23, 2025 (3 updates tracked since 2025).

About Mr. Phillip Wayne Clark Dnp NPPES

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

MR. PHILLIP WAYNE CLARK DNP (NPI 1629471412) is an individual family provider in Creve Coeur, Missouri, licensed in Arizona (AP 7468) and active in the NPI registry since October 2014. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1629471412
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. PHILLIP WAYNE CLARKCredential: DNP
Location Address11560 OLIVE BLVDCreve Coeur, MO 63141-7111
Mailing Address11560 Olive BlvdCreve Coeur, MO 63141-7111 · (314) 995-7128 · Fax (314) 995-7221
Phone(314) 995-7128
Fax(314) 995-7221
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateOctober 7, 2014
Last NPPES UpdateMarch 31, 20263 updates tracked since enumeration
NPPES CertifiedMarch 31, 2026
✔ NPI 1629471412 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 AZ · AP 7468✔ Licensed in NM · CNP-02553✔ Licensed in MO · 2014034806
11560 OLIVE BLVD, Creve Coeur, MO 63141
Open in Google Maps ↗

Secondary Practice Locations 3

Location 13100 Oak Grove RdPoplar Bluff, MO 63901-1573 · Phone (573) 776-9290 · Fax (659) 235-6176
Location 22501 N Stockton Hill Rd Ste 108Kingman, AZ 86401-4140 · Phone (928) 255-5050 · Fax (888) 571-5897
Location 3150 E. Tyson RdQuartzsite, AZ 85359-4618 · Phone (928) 927-8749 · Fax (928) 927-8748

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, UnitedHealthcare.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

Mr. Phillip Wayne Clark Dnp 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 ID1557671864
PECOS Enrollment IDI20260424000708
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 63141 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
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.

MISSOURI CVS PHARMACY, L.L.C.
Pharmacy
11560 OLIVE BLVD
CREVE COEUR, MO 63141
St. Louis County (314) 995-7128
BRITTANY WORT
Nurse Practitioner (Family)
11560 OLIVE BLVD
CREVE COEUR, MO 63141
St. Louis County (314) 995-7128
DR. CLAIRE ELIZABETH JENSEN DNP, APRN, FNP-BC
Nurse Practitioner (Family)
11560 OLIVE BLVD
CREVE COEUR, MO 63141
St. Louis County (314) 995-7128
JUSTIN HODGES
Pharmacist
11560 OLIVE BLVD
SAINT LOUIS, MO 63141
St. Louis County (314) 995-7128
ALYSSA KATHERINE ROWE FNP-BC
Nurse Practitioner (Family)
11560 OLIVE BLVD
CREVE COEUR, MO 63141
St. Louis County (314) 995-7128
DR. ZACHARY NELSON PHARMD
Pharmacist
11560 OLIVE BLVD
CREVE COEUR, MO 63141
St. Louis County (314) 995-7128
ADAM ARNOLD PHARMD
Pharmacist
11560 OLIVE BLVD
SAINT LOUIS, MO 63141
St. Louis County (314) 995-7128
THOMAS EVAN SUDDETH
Pharmacist
11560 OLIVE BLVD
CREVE COEUR, MO 63141
St. Louis County (314) 995-7128

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 Phillip Clark's NPI number?

The NPI number for Phillip Clark is 1629471412. It was assigned to this individual provider in the NPPES registry on October 7, 2014.

Where is Phillip Clark located?

Phillip Clark practices at 11560 Olive Blvd, Creve Coeur, MO 63141. The listed phone number is (314) 995-7128.

What is Phillip Clark's specialty?

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

Is Phillip Clark enrolled in Medicare?

Yes. Phillip Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Phillip Clark accept?

Health plans from Blue Cross Blue Shield of Arizona and UnitedHealthcare list Phillip Clark 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 Phillip Clark was last updated on March 31, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.