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Nicholas Clark , LPN

Licensed Practical Nurse β€’ Evanston, WY

Active NPI 1538657465 Individual Practitioner Male Practitioner
Practice location in NPPES

350 City View Dr Ste 206
Evanston, WY 82930

Call 3077897915 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

350 City View Dr Ste 206

Evanston, WY 82930

Telephone 3077897915
Organization at the Same NPPES Address or Phone
Pioneer Counseling Services Facility NPI 1003651431

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Evanston and Wyoming

7 active clinicians are listed under Licensed Practical Nurse with a practice address in Evanston, WY (55 in Wyoming).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

License # reported to NPPES WY 8096

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Wyoming State Medical Licensing Board.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
NPI 1598988636

Licensed Professional Counselor

Vickie Wood , LCSW

Social Worker - Clinical

NPI 1528287018

Licensed Clinical Social Worker

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location May 29, 2018

Registered at 350 CITY VIEW DR STE 206, EVANSTON, WY 82930 (Tel: 3077897915)

πŸ‘€
Provider Name / Credentials Updated May 29, 2018

Recorded as NICHOLAS CLARK, LPN

βœ…
NPI Profile Active April 26, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 26, 2018

Registered at 350 CITY VIEW DR STE 206, EVANSTON, WY 829305326 (Tel: 3077897915)

πŸ“
Business Mailing Address (Initial Record) April 26, 2018

Registered at 350 CITY VIEW DR STE 206, EVANSTON, WY 829305326 (Tel: 3077897915)

πŸ‘€
Provider Name / Credentials (Initial Record) April 26, 2018

Recorded as NICK CLARK, LPN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 26, 2018

Licensed Practical Nurse (license number reported to NPPES: WY 8096)

🟒
Initial NPI Registration & Enumeration April 26, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1538657465
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 26, 2018
Last Update: May 29, 2018
Sole Proprietor: No

Mailing Address

350 City View Dr Ste 206

Evanston, WY 829305326

Phone: 3077897915

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.