CLARK JOSEPH WYATT (NP-C) – Family Nurse Practitioner, NPI 1215448246

CLARK JOSEPH WYATT (NP-C) is a healthcare provider. based in Kimberly, Idaho. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. 57139 (ID). The NPI Number for CLARK JOSEPH WYATT (NP-C) is 1215448246

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
CLARK JOSEPH WYATT (NP-C)
NPI
1215448246
Phone
(208) 490-1901
Address
1131 COLE ST
Enumeration Date
17 October 2017
Last Update Date
17 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2086781049
Graduation Year
2017 (9 years ago)
PAC ID
9234491820
Group Practice PAC ID
7416943782
Professional Enrollment ID
I20180319002478
Address ID
ID833184906BU1263XAVEX303
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

1,802 NURSE PRACTITIONER in ID

Provider Addresses for CLARK JOSEPH WYATT (NP-C)

  • 1131 COLE ST

    KIMBERLY, ID 833415138

    Phone: (208) 490-1901

    Type: Mailing

  • 1502 LOCUST ST N STE 600

    TWIN FALLS, ID 833014164

    Phone: (208) 734-6091

    Fax: (208) 734-4654

    Type: Location

  • Twin Falls, Twin Falls County, Idaho, 83301, United States

    TWIN FALLS, ID 833013370

    Phone: (208) 736-7422

    Fax: (208) 736-8905

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 105 Open Payments records for all available years, with a total value of $3,107.

Total Amount is formed as General ($3,107) + Research ($0) + Ownership ($0) = $3,107.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Genentech USA, Inc. ($893).

Total Amount

$3,107

General + Research + Ownership

Payments

105

Total payment records

General Amount

$3,107

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-07-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180319002478INurse PractitionerIDTBD
I20190621002711INurse PractitionerNVTBD
I20230718002359INurse PractitionerUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
95004Test for allergy using allergenic extract1,00818$0
99213Established patient office or other outpatient visit, 20-29 minutes10680$0
96372Injection of drug or substance under skin or into muscle7821$0
94010Test to measure expiratory airflow and volume6547$0
Q3014Telehealth originating site facility fee4431$0
View full utilization report →

Insurance plans in this area (ZIP 83341)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416943782View full group profile
NameSpecialtyState
A L L E R G Y/ I M M U N O L O G YMD
Internal Medicine, Allergy/ImmunologyID
Nurse PractitionerID
Allergy/Immunology, Pediatric MedicineID

Reviews

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Frequently asked questions

What is the registry number for CLARK JOSEPH WYATT (NP-C)?
The registry entry for CLARK JOSEPH WYATT (NP-C) shows NPI 1215448246.
Quick check: is CLARK JOSEPH WYATT (NP-C) active?
Public NPPES data shows CLARK JOSEPH WYATT (NP-C) with an active NPI status right now.
How should patients interpret CLARK JOSEPH WYATT (NP-C)'s specialty?
The extract shows Family Nurse Practitioner for CLARK JOSEPH WYATT (NP-C). Clinical services aligned with this taxonomy classification.
What city is tied to CLARK JOSEPH WYATT (NP-C)?
The directory associates CLARK JOSEPH WYATT (NP-C) with Kimberly, Idaho. Check all listed addresses for suites or satellite offices.
Who maintains CLARK JOSEPH WYATT (NP-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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