DR. AMY JO CLARK (APNP) – Family Nurse Practitioner, NPI 1265969356
Family Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
6,035 NURSE PRACTITIONER in WI
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Provider Addresses for DR. AMY JO CLARK (APNP)
407, Grant Avenue, Sheboygan, Sheboygan County, Wisconsin, 53081, United States
SHEBOYGAN, WI 530812857
Phone:
Type: Mailing
950, Woodlake Road, Kohler, Sheboygan County, Wisconsin, 53044, United States
KOHLER, WI 530441348
Phone: (920) 783-3150
Type: Location
1621 N TAYLOR DR STE 100
SHEBOYGAN, WI 530811993
Phone: (920) 452-1650
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 70 Open Payments records for all available years, with a total value of $2,224.
Total Amount is formed as General ($2,224) + Research ($0) + Ownership ($0) = $2,224.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Exelixis Inc. ($195).
Total Amount
$2,224
General + Research + Ownership
Payments
70
Total payment records
General Amount
$2,224
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Exelixis Inc. | $195 |
| Novartis Pharmaceuticals Corporation | $150 |
| GENZYME CORPORATION | $132 |
| SOBI, INC | $125 |
| Incyte Corporation | $118 |
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: 2017-09-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170918001049 | I | Nurse Practitioner | WI | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 53081)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Nurse Practitioner | WI | |
| Internal Medicine | WI | |
| Internal Medicine | WI | |
| - | WI | |
| Internal Medicine | WI | |
| Nurse Practitioner | WI | |
| H E M A T O L O G Y/ O N C O L O G Y | WI | |
| Internal Medicine | WI | |
| - | WI |
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