Nadia Shanise Clark, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Bassfield, Mississippi. She graduated from nursing school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Pioneer Health Care , Llc and her current practice location is
4297 Us Highway 42, Bassfield, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(601) 943-5060.
Nadia Shanise Clark is licensed to practice in Mississippi (license number 904907) 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 1689345506.
Provider's Profile
| Full Name | Nadia Shanise Clark |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 3 Years |
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| Location | 4297 Us Highway 42, Bassfield, Mississippi |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Nadia Shanise Clark graduated from nursing school in 2021
NPI Data:
- NPI Number: 1689345506
- Provider Enumeration Date: 09/21/2021
- Last Update Date: 03/02/2023
Medicare PECOS Information:
- PECOS PAC ID: 3870987787
- Enrollment ID: I20220218000291
Medical Identifiers
Medical identifiers for Nadia Shanise Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689345506 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 904907 (Mississippi) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Pioneer Health Care , Llc | 4789740044 | 13 |
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. Nadia Shanise Clark allows following entities to bill medicare on her behalf.
| Entity Name | Pioneer Health Care , Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336384742
PECOS PAC ID: 4789740044
Enrollment ID: O20090311000659 |
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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. Nadia Shanise 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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Nadia Shanise Clark, FNP-C
8 Sequatchie,
Hattiesburg, MS 39402-1269
Ph: (601) 410-7189 | Nadia Shanise Clark, FNP-C
4297 Us Highway 42,
Bassfield, MS 39421
Ph: (601) 943-5060 |
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