Vivian M Clark, MD - Medicare Internal Medicine in Elizabethton, TN

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Vivian M Clark, MD is a medicare enrolled "Internal Medicine" physician in Elizabethton, Tennessee. Her current practice location is 1503 W Elk Ave, Suite 5, Elizabethton, Tennessee. You can reach out to her office (for appointments etc.) via phone at (423) 542-0400.

Vivian M Clark is licensed to practice in Tennessee (license number 39360) 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 1205889508.

Contact Information

Vivian M Clark, MD
1503 W Elk Ave, Suite 5,
Elizabethton, TN 37643-2876
(423) 542-0400
(423) 542-3265

Map and Direction




Physician's Profile

Full NameVivian M Clark
GenderFemale
SpecialityInternal Medicine
Location1503 W Elk Ave, Elizabethton, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1205889508
  • Provider Enumeration Date: 05/18/2006
  • Last Update Date: 03/17/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 1456301548
  • Enrollment ID: I20050126000813

Medical Identifiers

Medical identifiers for Vivian M Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205889508NPI-NPPES
4146001OtherTNBCBS OF TENNESSEE
TN0109OtherTNJOHN DEEREUHC
3326510MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine MD39360 (Tennessee)Secondary
207R00000XInternal Medicine 39360 (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. Vivian M Clark allows following entities to bill medicare on her behalf.
Entity NameSoutheastern Physician Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083835441
PECOS PAC ID: 0042307852
Enrollment ID: O20071025000571
Entity NameIpc Pac Healthcare Services Of Tennessee Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104277656
PECOS PAC ID: 0840587572
Enrollment ID: O20160928000541
Entity NameNv Pacs 2 Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1427534809
PECOS PAC ID: 0941550578
Enrollment ID: O20210903001263

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. Vivian M 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
Vivian M Clark, MD
1503 W Elk Ave, Suite 5,
Elizabethton, TN 37643-2876

Ph: (423) 542-0400		Vivian M Clark, MD
1503 W Elk Ave, Suite 5,
Elizabethton, TN 37643-2876

Ph: (423) 542-0400

Reviews and Comments


Internal Medicine Doctors in Elizabethton, TN

Abigail Gass, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1503 W Elk Ave Ste 5, Elizabethton, TN 37643
Phone: 423-542-0400    
Dr. Makram Jurdi, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1501 W. Elk St, Elizabethton, TN 37643
Phone: 423-282-1480    Fax: 423-928-1353
Jonathan Scott Bremer, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1503 W Elk Ave, Suite 8, Elizabethton, TN 37643
Phone: 423-542-0400    Fax: 423-542-0201
Dr. Michelle Lee Davenport, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 306 Pine Hill Rd, Elizabethton, TN 37643
Phone: 423-542-4189    Fax: 423-542-4181

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.