Katherine Sue Clark, APRN is a medicare enrolled "Nurse Practitioner - Family" in Stokesdale, North Carolina. Her current practice location is
7700 Us Highway 158, Stokesdale, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(800) 226-8874.
Katherine Sue Clark is licensed to practice in North Carolina (license number 501887) 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 1376220798.
Provider's Profile
| Full Name | Katherine Sue Clark |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 7700 Us Highway 158, Stokesdale, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1376220798
- Provider Enumeration Date: 06/28/2023
- Last Update Date: 01/29/2024
Medicare PECOS Information:
- PECOS PAC ID: 9436504867
- Enrollment ID: I20231004003736
Medical Identifiers
Medical identifiers for Katherine Sue Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1376220798 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | APRN11023419 (Florida) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | GAA-NP001335 (Georgia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 501887 (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. Katherine Sue Clark allows following entities to bill medicare on her behalf.
| Entity Name | Quality Surgical Management Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1184808586
PECOS PAC ID: 2961583471
Enrollment ID: O20080122000521 |
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| Entity Name | Qsm-nc Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881136893
PECOS PAC ID: 1052695798
Enrollment ID: O20170224001600 |
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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. Katherine Sue 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 |
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Katherine Sue Clark, APRN
3791 S Cranberry Blvd,
North Port, FL 34286-4310
Ph: (941) 266-3681 | Katherine Sue Clark, APRN
7700 Us Highway 158,
Stokesdale, NC 27357-9346
Ph: (800) 226-8874 |
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