CLARK, NELSON, AND ASSOCIATES, INC.
NPI 1902457450
Nurse Practitioner - Family in Chicago, IL
About Clark, Nelson, And Associates, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLARK, NELSON, AND ASSOCIATES, INC. (NPI 1902457450) is a healthcare organization registered as a family in Chicago, Illinois and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through November 8, 2027, maintains a secondary practice location in West Jordan, and lists Shammona Clark, Family Nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Location 1
Group Practice 2
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)
Clark, Nelson, And Associates, Inc. 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 Clark, Nelson, And Associates, Inc., which bills Medicare for the services they deliver. 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 14D2242480
Clark, Nelson, And Associates, Inc · Chicago, ILFrequently 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 Clark, Nelson, And Associates, Inc.'s NPI number?
The NPI number for Clark, Nelson, And Associates, Inc. is 1902457450. It was assigned to this organization in the NPPES registry on September 26, 2019.
Where is Clark, Nelson, And Associates, Inc. located?
Clark, Nelson, And Associates, Inc. is located at 2600 S Michigan Ave Ste Lld, Chicago, IL 60616. The listed phone number is (312) 866-4642.
What is Clark, Nelson, And Associates, Inc.'s specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Clark, Nelson, And Associates, Inc. enrolled in Medicare?
Yes. Clark, Nelson, And Associates, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Clark, Nelson, And Associates, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Clark, Nelson, And Associates, Inc.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Clark, Nelson, And Associates, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 14D2242480) is associated with this NPI, valid through November 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Clark, Nelson, And Associates, Inc. accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Clark, Nelson, And Associates, Inc. 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 Clark, Nelson, And Associates, Inc. was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Clark, Nelson, And Associates, Inc. · NPI 1902457450
Family organization in Chicago, Illinois. Organization record, active in the CMS NPPES registry since September 26, 2019.
## Identity
- **NPI:** 1902457450 (Entity type: Organization)
- **Enumerated:** September 26, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Also known as:** Clark, Nelson, and Associates, Inc. (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Shammona Clark, FAMILY NURSE PRACTITIONER
## Practice location
- **Address:** 2600 S MICHIGAN AVE, STE LLD, Chicago, IL 60616
- **Phone:** (312) 866-4642
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 11, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1902457450) · Data from the CMS NPPES public registry.