Jared Dale Clark, APN in Texarkana, AR - Medicare Nurse Practitioner

Jared Dale Clark, APN is a medicare enrolled "Nurse Practitioner - Gerontology" in Texarkana, Arkansas. He graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice East Texas Border Health Clinic, East Texas Border Health Clinic and his current practice location is 4077 Jefferson Ave, Texarkana, Arkansas. You can reach out to his office (for appointments etc.) via phone at (870) 330-9200.

Jared Dale Clark is licensed to practice in Texas (license number AP141588) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1467011239.

Contact Information

	Jared Dale Clark, APN
	4077 Jefferson Ave, Texarkana, AR 71854-1509
	(870) 330-9200
	Not Available

Map and Direction

Provider's Profile

Full Name	Jared Dale Clark
Gender	Male
Speciality	Nurse Practitioner
Experience	5 Years
Location	4077 Jefferson Ave, Texarkana, Arkansas
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jared Dale Clark graduated from nursing school in 2019

NPI Data:

NPI Number: 1467011239
Provider Enumeration Date: 06/06/2019
Last Update Date: 08/28/2023

Medicare PECOS Information:

PECOS PAC ID: 6406182260
Enrollment ID: I20190731003397

Medical Identifiers

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

Identifier	Type	State	Issuer
1467011239	NPI	-	NPPES
AP141588	Other	TX	APN LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LG0600X	Nurse Practitioner - Gerontology	AP141588 (Texas)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Christus St Michael Health System	Texarkana, TX	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
East Texas Border Health Clinic	8820038565	39
East Texas Border Health Clinic	8820038565	39

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. Jared Dale Clark allows following entities to bill medicare on his behalf.

Entity Name	East Texas Border Health Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558329797 PECOS PAC ID: 8820038565 Enrollment ID: O20050511001030

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. Jared Dale 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
Jared Dale Clark, APN Po Box 1326, Marshall, TX 75671-1326 Ph: (903) 927-3782	Jared Dale Clark, APN 4077 Jefferson Ave, Texarkana, AR 71854-1509 Ph: (870) 330-9200

Reviews and Comments

Nurse Practitioner Nurses in Texarkana, AR

Tommy Caldwell, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1205 E 35th St, Texarkana, AR 71854 Phone: 903-614-5355 Fax: 903-614-5399
Deborah L Porchia, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 300 E 6th St, Texarkana, AR 71854 Phone: 870-779-6000 Fax: 870-779-6125
Mrs. Crystal Marie Stanberry, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1205 E 35th St, Texarkana, AR 71854 Phone: 903-735-5355
Ms. Gracie Mae Adkisson, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2301 Pecan St, Texarkana, AR 71854 Phone: 903-278-5906
Belinda K Doss, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 401 East St, Texarkana, AR 71854 Phone: 870-773-2177 Fax: 870-773-2758
Porscha Nicole Branch, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1205 E 35th St, Texarkana, AR 71854 Phone: 870-216-0050 Fax: 870-216-0096
Mrs. Martega Marie Walton, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1307 Trinity Blvd, Texarkana, AR 71854 Phone: 870-773-6467 Fax: 870-216-0061

Jared Dale Clark, APN - Medicare Nurse Practitioner in Texarkana, AR