Jennifer Lee Clark, NURSE PRACTITIONER - Medicare Nurse Practitioner in Gray, GA

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Jennifer Lee Clark, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Family" in Gray, Georgia. Her current practice location is 1005 Boulder Dr, Gray, Georgia. You can reach out to her office (for appointments etc.) via phone at (478) 621-2100.

Jennifer Lee Clark is licensed to practice in Georgia (license number RN173733) 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 1265661045.

Contact Information

Jennifer Lee Clark, NURSE PRACTITIONER
1005 Boulder Dr,
Gray, GA 31032
(478) 621-2100
(478) 744-0481

Map and Direction




Provider's Profile

Full NameJennifer Lee Clark
GenderFemale
SpecialityNurse Practitioner - Family
Location1005 Boulder Dr, Gray, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1265661045
  • Provider Enumeration Date: 07/14/2009
  • Last Update Date: 07/17/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 1052602349
  • Enrollment ID: I20160616000793

Medical Identifiers

Medical identifiers for Jennifer Lee Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265661045NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family RN173733 (Georgia)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. Jennifer Lee Clark allows following entities to bill medicare on her behalf.
Entity NameCommunity Primary Care Of Georgia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336492511
PECOS PAC ID: 0648421065
Enrollment ID: O20121113000274

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. Jennifer Lee 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
Jennifer Lee Clark, NURSE PRACTITIONER
1005 Boulder Dr,
Gray, GA 31032-6141

Ph: (478) 621-2100		Jennifer Lee Clark, NURSE PRACTITIONER
1005 Boulder Dr,
Gray, GA 31032

Ph: (478) 621-2100

Reviews and Comments


Nurse Practitioner Nurses in Gray, GA

Natalie F Evans, NP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 260 W Clinton St, Gray, GA 31032
Phone: 478-986-4743    
Mrs. Brenda Gail Tolleson, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1005 Boulder Dr, Gray, GA 31032
Phone: 478-621-2100    Fax: 478-744-0481
Mrs. Leslie Busbee Miller, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1005 Boulder Dr, Gray, GA 31032
Phone: 478-621-2100    Fax: 478-744-0481
Michael Kelly, APRN, NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1005 Boulder Dr, Gray, GA 31032
Phone: 478-621-2100    Fax: 478-744-0481
Mrs. Marie Rosemonde Nozil, MSN, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1005 Boulder Dr, Gray, GA 31032
Phone: 678-334-7218    
Mrs. Catherine Marie Wilson, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1005 Boulder Dr, Gray, GA 31032
Phone: 478-621-2100    Fax: 478-744-0481

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.