Debra Clark, PNP in Concord, NC - Medicare Nurse Practitioner

Debra Clark, PNP is a medicare enrolled "Nurse Practitioner - Pediatrics" in Concord, North Carolina. Her current practice location is 1040 Vinehaven Dr Ne, Concord, North Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 784-1010.

Debra Clark is licensed to practice in North Carolina (license number 5007863) 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 1336525625.

Contact Information

	Debra Clark, PNP
	1040 Vinehaven Dr Ne, Concord, NC 28025-2438
	(704) 784-1010
	(704) 784-1013

Map and Direction

Provider's Profile

Full Name	Debra Clark
Gender	Female
Speciality	Nurse Practitioner - Pediatrics
Location	1040 Vinehaven Dr Ne, Concord, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1336525625
Provider Enumeration Date: 08/10/2015
Last Update Date: 08/02/2024

Medicare PECOS Information:

PECOS PAC ID: 9638488398
Enrollment ID: I20151020000364

Medical Identifiers

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

Identifier	Type	State	Issuer
1336525625	NPI	-	NPPES
1336525625	Medicaid	NC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	5007863 (North Carolina)	Secondary
363LP0200X	Nurse Practitioner - Pediatrics	5007863 (North Carolina)	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. Debra Clark allows following entities to bill medicare on her behalf.

Entity Name	Novant Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692

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. Debra 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
Debra Clark, PNP 1040 Vinehaven Dr Ne, Concord, NC 28025-2438 Ph: (704) 784-1010	Debra Clark, PNP 1040 Vinehaven Dr Ne, Concord, NC 28025-2438 Ph: (704) 784-1010

Reviews and Comments

Nurse Practitioner Nurses in Concord, NC

Lori Lovett Robinson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1090 Ne Gateway Ct Ne, Ste 202, Concord, NC 28025 Phone: 704-403-9050
Mrs. Laura Hudson Werner, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5225 Poplar Tent Rd, Concord, NC 28027 Phone: 704-782-1727
Nicole Elizabeth Longo, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1090 Ne Gateway Ct Ne, Ste 202, Concord, NC 28025 Phone: 704-403-9050
Jason K Freeburne, ARNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 101 Cabarrus Ave E, Concord, NC 28025 Phone: 888-849-7379 Fax: 855-857-7333
Temple Britt Byrd, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 101 Cabarrus Ave E Ste 200, Concord, NC 28025 Phone: 888-849-7379 Fax: 855-857-7333
John Emmett Fesperman, FNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 101 Cabarrus Ave E, Concord, NC 28025 Phone: 888-849-7379 Fax: 855-857-7333
Kimberly Smith Gallagher, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 349 Penny Ln, Concord, NC 28025 Phone: 704-786-7158

Debra Clark, PNP - Medicare Nurse Practitioner in Concord, NC