Mr Jeremiah Robins Clark, FNP-BC in Rexburg, ID

Mr Jeremiah Robins Clark, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Rexburg, Idaho. His current practice location is 600 Pioneer Rd Apt 1320, Rexburg, Idaho. You can reach out to his office (for appointments etc.) via phone at (269) 428-7228.

Mr Jeremiah Robins Clark is licensed to practice in Idaho (license number TEMP77813) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1356123657.

Contact Information

	Mr Jeremiah Robins Clark, FNP-BC
	600 Pioneer Rd Apt 1320, Rexburg, ID 83440-3711
	(269) 428-7228
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Jeremiah Robins Clark
Gender	Male
Speciality	Nurse Practitioner - Family
Location	600 Pioneer Rd Apt 1320, Rexburg, Idaho
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1356123657
Provider Enumeration Date: 10/20/2023
Last Update Date: 10/20/2023

Medicare PECOS Information:

PECOS PAC ID: 0446695118
Enrollment ID: I20240304003420

Medical Identifiers

Medical identifiers for Mr Jeremiah Robins Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1356123657	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	TEMP77813 (Idaho)	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. Mr Jeremiah Robins Clark allows following entities to bill medicare on his behalf.

Entity Name	Meridian Advanced Psychiatry , Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609412683 PECOS PAC ID: 8628490711 Enrollment ID: O20200618000604

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. Mr Jeremiah Robins 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
Mr Jeremiah Robins Clark, FNP-BC 600 Pioneer Rd Apt 1320, Rexburg, ID 83440-3711 Ph: (269) 428-7228	Mr Jeremiah Robins Clark, FNP-BC 600 Pioneer Rd Apt 1320, Rexburg, ID 83440-3711 Ph: (269) 428-7228

Reviews and Comments

Nurse Practitioner Nurses in Rexburg, ID

Bryce Campbell, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-359-6900
Troy Hanson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-356-3691
Annette Mary Tuft, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 404 N 2nd E, Rexburg, ID 83440 Phone: 208-359-1770 Fax: 208-359-1780
Beyron Alexis Zecher, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-359-6900
Nichole Ann Jeppesen, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10 Madison Professional Park, Rexburg, ID 83440 Phone: 208-656-9467 Fax: 208-656-9466
Arleigh Nash, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 72 S 1st E Ste 101, Rexburg, ID 83440 Phone: 208-356-4900 Fax: 208-359-1600

Mr Jeremiah Robins Clark, FNP-BC - Medicare Nurse Practitioner in Rexburg, ID