SHAMMONA CLARK (FNP-C) – Family Nurse Practitioner, NPI 1235785809

SHAMMONA CLARK (FNP-C) is a healthcare provider. based in Chicago, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 209020109 (IL). The NPI Number for SHAMMONA CLARK (FNP-C) is 1235785809

Main info

Female
7 Years Of Experience
Name
SHAMMONA CLARK (FNP-C)
NPI
1235785809
Phone
(574) 298-3090
Address
7708 S CONSTANCE AVE
Enumeration Date
9 August 2019
Last Update Date
31 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2246339472
Graduation Year
2019 (7 years ago)
PAC ID
4587098520
Group Practice PAC ID
3375894900
Professional Enrollment ID
I20200103001384
Address ID
IL606114742CH401XXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

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Provider Addresses for SHAMMONA CLARK (FNP-C)

  • 7708, South Constance Avenue, South Shore, Chicago, Hyde Park Township, Cook County, Illinois, 60649, United States

    CHICAGO, IL 606494608

    Phone: (574) 298-3090

    Type: Location

  • 9133 S STONY ISLAND AVE

    CHICAGO, IL 606173512

    Phone: (574) 298-3090

    Type: Location

  • 2600 S MICHIGAN AVE

    STE LLD

    CHICAGO, IL 60616

    Phone: (312) 866-4642

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 131 Open Payments records for all available years, with a total value of $128,475.

Total Amount is formed as General ($128,475) + Research ($0) + Ownership ($0) = $128,475.

Last reported payment date: 2024-11-08 • Largest payer in this snapshot: Neurocrine BioSciences, Inc. ($115,293).

Total Amount

$128,475

General + Research + Ownership

Payments

131

Total payment records

General Amount

$128,475

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-08

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2020-01-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20200103001384INurse PractitionerILTBD

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
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes5422$0
View full utilization report →

Insurance plans in this area (ZIP 60649)

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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: 3375894900View full group profile
NameSpecialtyState
General SurgeryIL

Reviews

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Frequently asked questions

Is SHAMMONA CLARK (FNP-C) listed with a National Provider Identifier?
Yes — SHAMMONA CLARK (FNP-C) has NPI 1235785809 on file in the registry.
Is SHAMMONA CLARK (FNP-C) still an active registrant?
SHAMMONA CLARK (FNP-C) carries an active NPI according to the public dataset.
How would a patient describe SHAMMONA CLARK (FNP-C)'s focus?
For SHAMMONA CLARK (FNP-C), the primary taxonomy reads as Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Illinois is SHAMMONA CLARK (FNP-C) registered?
Use Chicago, Illinois as the headline location for SHAMMONA CLARK (FNP-C) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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