JENNIFER RAE CLARK (CPNP-PC) – Pediatric Nurse Practitioner, NPI 1982249926
Pediatric Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JENNIFER RAE CLARK (CPNP-PC)
2251 FM 646 RD W STE 155
DICKINSON, TX 775393256
Phone: (907) 350-8538
Type: Mailing
2800 E LEAGUE CITY PKWY APT 216
LEAGUE CITY, TX 775731676
Phone: (907) 350-8538
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $278.
Total Amount is formed as General ($278) + Research ($0) + Ownership ($0) = $278.
Last reported payment date: 2024-08-28 • Largest payer in this snapshot: PFIZER INC. ($187).
Total Amount
$278
General + Research + Ownership
Payments
7
Total payment records
General Amount
$278
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $187 |
| GlaxoSmithKline, LLC. | $24 |
| Merck Sharp & Dohme LLC | $23 |
| Cumberland Pharmaceuticals, Inc. | $15 |
| Cranial Technologies, Inc | $15 |
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: 2024-10-08
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 |
|---|---|---|---|---|
| I20241008001329 | I | Nurse Practitioner | TX | 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 77539)
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