Kerry R Clark, RD in Spokane, WA - Medicare Dietitian, Registered Provider

Kerry R Clark, RD is a medicare enrolled "Dietitian, Registered" provider in Spokane, Washington. Her current practice location is 101 W 8th Ave, Suite 1100, Spokane, Washington. You can reach out to her office (for appointments etc.) via phone at (509) 474-4060.

Kerry R Clark is licensed to practice in Washington (license number DI00000348) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114366168.

Contact Information

	Kerry R Clark, RD
	101 W 8th Ave, Suite 1100, Spokane, WA 99204-2307
	(509) 474-4060
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kerry R Clark
Gender	Female
Speciality	Dietitian, Registered
Location	101 W 8th Ave, Spokane, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114366168
Provider Enumeration Date: 06/21/2013
Last Update Date: 05/03/2021

Medicare PECOS Information:

PECOS PAC ID: 3577797596
Enrollment ID: I20131007000898

Medical Identifiers

Medical identifiers for Kerry R Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114366168	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	DI00000348 (Washington)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kerry R Clark allows following entities to bill medicare on her behalf.

Provider Name	Providence Health & Services Washington
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1881907715 PECOS PAC ID: 8729258256 Enrollment ID: O20110819000034

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kerry R Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kerry R Clark, RD Po Box 421, Liberty Lake, WA 99019-0421 Ph: (866) 747-2455	Kerry R Clark, RD 101 W 8th Ave, Suite 1100, Spokane, WA 99204-2307 Ph: (509) 474-4060

Reviews and Comments

Dietitian, Registered in Spokane, WA

Katherine Leigh Lefler, RD Dietitian Medicare: Medicare Enrolled Practice Location: 910 W 5th Ave, Suite 800, Spokane, WA 99204 Phone: 509-838-2531
Tessa Janelle Farr, REGISTERED DIETITIAN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 910 W 5th Ave Ste 800, Spokane, WA 99204 Phone: 509-838-2531 Fax: 509-755-6580
R. Tucker Reiley, MS, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 15404 N Addison Ct, Spokane, WA 99208 Phone: 833-378-2162
Breanna K Bergeron, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 212 E Central Ave, Ste. 440, Spokane, WA 99208 Phone: 509-252-9602 Fax: 509-227-7070
Erica Lynn Baty, MS, RD, CD Dietitian Medicare: Medicare Enrolled Practice Location: 3919 N Maple St, Spokane, WA 99205 Phone: 509-444-8200 Fax: 509-444-7806
Jaclyn Michele Helm, MS,RD,CD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2820 N Astor St, Spokane, WA 99207 Phone: 509-252-5792 Fax: 509-340-7323
Lisa Harmeyer, Dietitian Medicare: Medicare Enrolled Practice Location: 2020 E 29th Ave Ste 200, Spokane, WA 99203 Phone: 888-364-5977

Kerry R Clark, RD - Medicare Dietitian in Spokane, WA