MS. CARA CLARK (NURSE PRACTITIONER) – Neonatal Nurse Practitioner, NPI 1992731921
Neonatal Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. CARA CLARK (NURSE PRACTITIONER)
1500 S Main St
Fort Worth, TX 76104
Phone: (817) 702-1166
Type: Location
315 Martin Luther King Jr Way
MS Z0-NTL
Tacoma, WA 984054234
Phone: (253) 403-1019
Fax: (253) 403-1686
Type: Location
201, West Magnolia Avenue, Fort Worth, Tarrant County, Texas, 76104, United States
FORT WORTH, TX 761047657
Phone: (817) 702-2977
Type: Mailing
John Peter Smith Hospital, 1500, South Main Street, Fort Worth, Tarrant County, Texas, 76104, United States
FORT WORTH, TX 76104
Phone: (817) 702-1166
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $500.
Total Amount is formed as General ($500) + Research ($0) + Ownership ($0) = $500.
Last reported payment date: 2024-05-24 • Largest payer in this snapshot: Medtronic, Inc. ($500).
Total Amount
$500
General + Research + Ownership
Payments
2
Total payment records
General Amount
$500
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $500 |
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: 2016-03-29
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 |
|---|---|---|---|---|
| I20160329002613 | I | Nurse Practitioner | WA | 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 76104)
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