Nichole Louise Clark, FNP in Conway, SC - Medicare Nurse Practitioner

Nichole Louise Clark, FNP is a medicare enrolled "Nurse Practitioner - Family" in Conway, South Carolina. Her current practice location is 6372 Adrian Hwy, Conway, South Carolina. You can reach out to her office (for appointments etc.) via phone at (843) 333-7919.

Nichole Louise Clark is licensed to practice in South Carolina (license number 27159) 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 1780384446.

Contact Information

	Nichole Louise Clark, FNP
	6372 Adrian Hwy, Conway, SC 29526-5603
	(843) 333-7919
	Not Available

Map and Direction

Provider's Profile

Full Name	Nichole Louise Clark
Gender	Female
Speciality	Nurse Practitioner - Family
Location	6372 Adrian Hwy, Conway, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780384446
Provider Enumeration Date: 03/09/2023
Last Update Date: 03/09/2023

Medicare PECOS Information:

PECOS PAC ID: 6406211325
Enrollment ID: I20230428000920

Medical Identifiers

Medical identifiers for Nichole Louise Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780384446	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	27159 (South Carolina)	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. Nichole Louise Clark allows following entities to bill medicare on her behalf.

Entity Name	Carolina Quickcare Family Practice, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881360899 PECOS PAC ID: 0840682340 Enrollment ID: O20220113000087

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. Nichole Louise 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
Nichole Louise Clark, FNP 6372 Adrian Hwy, Conway, SC 29526-5603 Ph: (843) 333-7919	Nichole Louise Clark, FNP 6372 Adrian Hwy, Conway, SC 29526-5603 Ph: (843) 333-7919

Reviews and Comments

Nurse Practitioner Nurses in Conway, SC

Mrs. Danielle Karin Brown, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 251 University Blvd, Conway, SC 29526 Phone: 843-349-6543
Mr. Jonathan D. Briggs, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4300 Highway 90, Conway, SC 29526 Phone: 843-399-3377 Fax: 843-399-3378
Linda Lee Queen, ARPN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1608 Main St, Conway, SC 29526 Phone: 843-248-4700 Fax: 843-248-3145
Dr. Karen Jeanette Smith, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2996 E Highway 501, Conway, SC 29526 Phone: 843-347-2613
Betsy L Paul, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1113 Church St, Conway, SC 29526 Phone: 843-248-6269
Diana L Taylor, DNP, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 140 Professional Park Drive, Conway, SC 29526 Phone: 843-234-5678
Anooja Nair, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 834 Farrar Dr, Conway, SC 29526 Phone: 843-497-7275

Nichole Louise Clark, FNP - Medicare Nurse Practitioner in Conway, SC