Mrs Shantera Clark, FNP-C in Statesboro, GA - Medicare Nurse Practitioner

Mrs Shantera Clark, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Statesboro, Georgia. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Privia Medical Group Of Georgia Llc, Christopher Dennis Md Pllc and her current practice location is 630 Ogeechee Dr W, Statesboro, Georgia. You can reach out to her office (for appointments etc.) via phone at (478) 456-0238.

Mrs Shantera Clark is licensed to practice in Georgia (license number RN220889) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1962020057.

Contact Information

	Mrs Shantera Clark, FNP-C
	630 Ogeechee Dr W, Statesboro, GA 30461-6753
	(478) 456-0238
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Shantera Clark
Gender	Female
Speciality	Nurse Practitioner
Experience	5 Years
Location	630 Ogeechee Dr W, Statesboro, Georgia
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Shantera Clark graduated from nursing school in 2019

NPI Data:

NPI Number: 1962020057
Provider Enumeration Date: 07/06/2020
Last Update Date: 08/04/2022

Medicare PECOS Information:

PECOS PAC ID: 6608274527
Enrollment ID: I20211007001273

Medical Identifiers

Medical identifiers for Mrs Shantera Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962020057	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	RN220889 (Georgia)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Privia Medical Group Of Georgia Llc	4284951542	332
Christopher Dennis Md Pllc	7416254990	48

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 Shantera Clark allows following entities to bill medicare on her behalf.

Entity Name	Privia Medical Group Of Georgia Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013313857 PECOS PAC ID: 4284951542 Enrollment ID: O20150325000983

Entity Name	Christopher Dennis Md Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588090229 PECOS PAC ID: 7416254990 Enrollment ID: O20190327002643

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 Shantera 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
Mrs Shantera Clark, FNP-C Po Box 1964, Statesboro, GA 30459-1964 Ph: (478) 456-0238	Mrs Shantera Clark, FNP-C 630 Ogeechee Dr W, Statesboro, GA 30461-6753 Ph: (478) 456-0238

Reviews and Comments

Nurse Practitioner Nurses in Statesboro, GA

Jenna Cottrell, MSN, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 586 Brannen St, Statesboro, GA 30458 Phone: 912-871-6611
Mrs. Kacy H. Nesmith, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1140 Brampton Ave, Statesboro, GA 30458 Phone: 912-871-2273
Tina L. Hathaway, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 114 Hill Pond Ln, Statesboro, GA 30458 Phone: 912-681-6944 Fax: 912-681-8744
Mrs. Qian Tang, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 106 Briarwood Rd, Statesboro, GA 30458 Phone: 912-871-5000 Fax: 912-681-1444
Jennifer Reddish Coulter, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1094 Bermuda Run, Statesboro, GA 30458 Phone: 912-681-3111
Mrs. Shelby Jordan Palmerton Graham, MSN, APRN, WHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 W Altman St, Statesboro, GA 30458 Phone: 912-764-0737
Ms. Connie June Barnett, RN, MSN, APRN-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 23702 Highway 80 E, Statesboro, GA 30461 Phone: 912-489-4090

Mrs Shantera Clark, FNP-C - Medicare Nurse Practitioner in Statesboro, GA