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JENNIFER JOANN CLARK NP
NPI 1710355615
Nurse Practitioner - Family in Anderson, MO

Active since September 09, 2015PECOS Enrolled
104 E MAIN ST, ANDERSON, MO 64831(417) 845-6984(417) 845-6976 Get Directions Write a Review

NPPES record last updated: June 26, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 13, 2017, Aug 9, 2016, Nov 24, 2015 (3 updates tracked since 2015).

About Jennifer Joann Clark Np NPPES

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

JENNIFER JOANN CLARK NP (NPI 1710355615) is an individual family provider in Anderson, Missouri, licensed in Missouri (2015031288) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Carthage.

NPPES Registry Identity

NPI1710355615
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJENNIFER JOANN CLARKCredential: NP
Location Address104 E MAIN STAnderson, MO 64831-4103
Mailing Address104 E Main StAnderson, MO 64831-4103 · (417) 845-6984 · Fax (417) 845-6976
Phone(417) 845-6984
Fax(417) 845-6976
Sole ProprietorNo
Enumeration DateSeptember 9, 2015
Last NPPES UpdateJune 26, 20193 updates tracked since enumeration
✔ NPI 1710355615 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
License✔ Licensed in MO · 2015031288
104 E MAIN ST, Anderson, MO 64831
Open in Google Maps ↗

Secondary Practice Location 1

Location 1327 E Airport DrCarthage, MO 64836-3402 · Phone (417) 237-0604 · Fax (417) 237-0613

Other Identifiers 3

Medicaid201119140AKS
Medicaid1710355615MO
Medicaid200605370AOK

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Joann Clark Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Jennifer Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

South Arkansas Emergency Physicians, LLP
26 mi
Emergency Medicine
3000 SE MEDICAL CENTER PKWY
Bentonville, AR 72712
  • Reassigned Medicare billing, Arkansas enrollment
  • 148 clinicians in this Medicare group
NPI 1447671490 (479) 553-1000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64831 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
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
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 4

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

SGOH ACQUISITION, INC.
Clinic/Center (Rural Health)
104 E MAIN ST
ANDERSON, MO 64831
McDonald County (417) 845-6984
MRS. GLADYS KABAMBA SMITH FAMILY NURSE PRACTIT
Nurse Practitioner (Family)
104 E MAIN ST
ANDERSON, MO 64831
McDonald County (417) 845-6984
JASON MYLIS BOWERS LCSW
Social Worker (Clinical)
104 E MAIN ST
ANDERSON, MO 64831
McDonald County (417) 845-6984
JULIA MARIE EDEN CNP
Nurse Practitioner (Family)
104 E MAIN ST
ANDERSON, MO 64831
McDonald County (417) 845-6984

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 Jennifer Clark's NPI number?

The NPI number for Jennifer Clark is 1710355615. It was assigned to this individual provider in the NPPES registry on September 9, 2015.

Where is Jennifer Clark located?

Jennifer Clark practices at 104 E Main St, Anderson, MO 64831. The listed phone number is (417) 845-6984.

What is Jennifer Clark's specialty?

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

Is Jennifer Clark enrolled in Medicare?

Yes. Jennifer Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jennifer Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Clark reassigns Medicare benefits to South Arkansas Emergency Physicians, LLP (Bentonville, AR). The 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 Jennifer Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jennifer Clark was last updated on June 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.