Mrs Kimberly Ann Clark, RN MSN FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Wheeler, Texas. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice North Wheeler County Hospital District and her current practice location is
307 East 9th Street, Wheeler, Texas. You can reach out to her office (for appointments etc.) via phone at
(580) 558-8543.
Mrs Kimberly Ann Clark is licensed to practice in Texas (license number 1014028) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1508405028.
Provider's Profile
| Full Name | Mrs Kimberly Ann Clark |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 307 East 9th Street, Wheeler, Texas |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Kimberly Ann Clark graduated from nursing school in 2020
NPI Data:
- NPI Number: 1508405028
- Provider Enumeration Date: 12/31/2019
- Last Update Date: 10/20/2020
Medicare PECOS Information:
- PECOS PAC ID: 1759791403
- Enrollment ID: I20201109000441
Medical Identifiers
Medical identifiers for Mrs Kimberly Ann Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1508405028 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163WC0400X | Registered Nurse - Case Management | 95760 (Oklahoma) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | F05200738 (Oklahoma) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 1014028 (Texas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| North Wheeler County Hospital District | 1254327232 | 2 |
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. Mrs Kimberly Ann Clark allows following entities to bill medicare on her behalf.
| Entity Name | North Wheeler County Hospital District |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1396748471
PECOS PAC ID: 1254327232
Enrollment ID: O20040423001044 |
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| Entity Name | North Wheeler County Hospital District |
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| Entity Type | Part A Provider - Critical Access Hospital |
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| Entity Identifiers | NPI Number: 1396748471
PECOS PAC ID: 1254327232
Enrollment ID: O20100917000444 |
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| Entity Name | North Wheeler County Hospital District |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1326445693
PECOS PAC ID: 1254327232
Enrollment ID: O20190403002525 |
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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. Mrs Kimberly Ann 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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Mrs Kimberly Ann Clark, RN MSN FNP-C
2401 Nw 13th St,
Lawton, OK 73507-2608
Ph: (580) 678-8081 | Mrs Kimberly Ann Clark, RN MSN FNP-C
307 East 9th Street,
Wheeler, TX 79096-1030
Ph: (580) 558-8543 |
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