Kiwanna Nishae Clark, FNP in Nashville, TN - Medicare Nurse Practitioner

Kiwanna Nishae Clark, FNP is a medicare enrolled "Nurse Practitioner - Family" in Nashville, Tennessee. Her current practice location is 426 21st Ave S # 7608, Nashville, Tennessee. You can reach out to her office (for appointments etc.) via phone at (615) 321-2590.

Kiwanna Nishae Clark is licensed to practice in Tennessee (license number 29323) 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 1235866898.

Contact Information

	Kiwanna Nishae Clark, FNP
	426 21st Ave S # 7608, Nashville, TN 37203-2424
	(615) 321-2590
	Not Available

Map and Direction

Provider's Profile

Full Name	Kiwanna Nishae Clark
Gender	Female
Speciality	Nurse Practitioner - Family
Location	426 21st Ave S # 7608, Nashville, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235866898
Provider Enumeration Date: 08/04/2022
Last Update Date: 08/04/2022

Medicare PECOS Information:

PECOS PAC ID: 7517343718
Enrollment ID: I20220926000795

Medical Identifiers

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

Identifier	Type	State	Issuer
1235866898	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	29323 (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. Kiwanna Nishae Clark allows following entities to bill medicare on her behalf.

Entity Name	Minuteclinic Diagnostic Of Tennessee Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457323164 PECOS PAC ID: 2961428990 Enrollment ID: O20051019000798

Entity Name	Crossroads Urgent Care Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366644361 PECOS PAC ID: 8325117484 Enrollment ID: O20080515000672

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. Kiwanna Nishae 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
Kiwanna Nishae Clark, FNP 3920 Puckett Creek Xing Apt 104, Murfreesboro, TN 37128-4251 Ph: (205) 563-0766	Kiwanna Nishae Clark, FNP 426 21st Ave S # 7608, Nashville, TN 37203-2424 Ph: (615) 321-2590

Reviews and Comments

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Kiwanna Nishae Clark, FNP - Medicare Nurse Practitioner in Nashville, TN