Nicole M Clark, PA-C is a medicare enrolled "Physician Assistant" in Saluda, South Carolina. She graduated from nursing school in 2008 and has 16 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Self Medical Group and her current practice location is
595 Newberry Hwy, Saluda, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(864) 445-2500.
Nicole M Clark is licensed to practice in South Carolina (license number 2017) 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 1114164142.
Provider's Profile
| Full Name | Nicole M Clark |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 16 Years |
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| Location | 595 Newberry Hwy, Saluda, South Carolina |
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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:
- Nicole M Clark graduated from nursing school in 2008
NPI Data:
- NPI Number: 1114164142
- Provider Enumeration Date: 01/13/2009
- Last Update Date: 12/21/2021
Medicare PECOS Information:
- PECOS PAC ID: 7810053212
- Enrollment ID: I20131226000996
Medical Identifiers
Medical identifiers for Nicole M Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114164142 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 2017 (South Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Self Medical Group | 6002953916 | 326 |
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. Nicole M 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 |
|---|
Nicole M Clark, PA-C
595 Newberry Hwy,
Saluda, SC 29138-7808
Ph: (864) 445-2500 | Nicole M Clark, PA-C
595 Newberry Hwy,
Saluda, SC 29138-7808
Ph: (864) 445-2500 |
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