Phillip Wayne Clark, DNP
NPI 1629471412ActiveIndividual· Nurse Practitioner, Family· Creve Coeur, MO
Nurse Practitioner, Family (DNP) in Creve Coeur, Missouri, licensed in AZ, NM and MO, with an NPI issued in October 2014. Part D covered 59 prescriptions written in 2024, 85% of them generic.
Overview
| NPI | 1629471412 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DNP |
| Sole proprietor | Yes |
| NPI issued | Oct 7, 2014 |
| Last updated in NPPES | Mar 31, 2026 |
| Certified by provider | Mar 31, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | AP 7468 | AZ |
| Nurse Practitioner, Family | 363LF0000X | CNP-02553 | NM |
| Nurse Practitioner, Family | 363LF0000X | 2014034806 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (AZ); Practitioner - Nurse Practitioner (MO) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 59 · 72 30-day fills |
|---|---|
| Patients | 12 |
| Total drug cost | $3,481 |
| Generic share | 85% of claims |
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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