Crystal Dawn Clark, FNP-BC - Medicare General Practice in Columbia, TN

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Crystal Dawn Clark, FNP-BC is a medicare enrolled "General Practice" physician in Columbia, Tennessee. Her current practice location is 1605 Nashville Hwy Ste 200, Columbia, Tennessee. You can reach out to her office (for appointments etc.) via phone at (931) 540-4210.

Crystal Dawn Clark is licensed to practice in Tennessee (license number 36529) 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 1457195380.

Contact Information

Crystal Dawn Clark, FNP-BC
1605 Nashville Hwy Ste 200,
Columbia, TN 38401-2132
(931) 540-4210
Not Available

Map and Direction




Physician's Profile

Full NameCrystal Dawn Clark
GenderFemale
SpecialityGeneral Practice
Location1605 Nashville Hwy Ste 200, Columbia, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1457195380
  • Provider Enumeration Date: 06/24/2024
  • Last Update Date: 06/24/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4688113269
  • Enrollment ID: I20240827003029

Medical Identifiers

Medical identifiers for Crystal Dawn Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1457195380NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208D00000XGeneral Practice 36529 (Tennessee)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. Crystal Dawn Clark allows following entities to bill medicare on her behalf.
Entity NameNorthside Medical Professionals, P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295044097
PECOS PAC ID: 8224224357
Enrollment ID: O20101201000188

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. Crystal Dawn 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 AddressPractice Location Address
Crystal Dawn Clark, FNP-BC
601 Florida Ave,
Mount Pleasant, TN 38474-1103

Ph: (931) 446-5778		Crystal Dawn Clark, FNP-BC
1605 Nashville Hwy Ste 200,
Columbia, TN 38401-2132

Ph: (931) 540-4210

Reviews and Comments


General Practice Doctors in Columbia, TN

Dr. David Glenn Ransom, M.D.
General Practice
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Practice Location: 1224 Trotwood Ave, Columbia, TN 38401
Phone: 931-381-1111    
David A Daniels, MD
General Practice
Medicare: Accepting Medicare Assignments
Practice Location: 1218 Trotwood Ave, Columbia, TN 38401
Phone: 931-490-7440    Fax: 931-490-7439

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.