Princess Clark, APRN in Alpharetta, GA - Medicare Nurse Practitioner

Princess Clark, APRN is a medicare enrolled "Nurse Practitioner - Family" in Alpharetta, Georgia. Her current practice location is 3905 Brookside Pkwy Ste 300, Alpharetta, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 442-1911.

Princess Clark is licensed to practice in Georgia (license number RN128145) 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 1679082549.

Contact Information

	Princess Clark, APRN
	3905 Brookside Pkwy Ste 300, Alpharetta, GA 30022-4458
	(770) 442-1911
	(770) 442-0306

Map and Direction

Provider's Profile

Full Name	Princess Clark
Gender	Female
Speciality	Nurse Practitioner - Family
Location	3905 Brookside Pkwy Ste 300, Alpharetta, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1679082549
Provider Enumeration Date: 09/23/2017
Last Update Date: 05/10/2024

Medicare PECOS Information:

PECOS PAC ID: 0749547578
Enrollment ID: I20171201002138

Medical Identifiers

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

Identifier	Type	State	Issuer
1679082549	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	RN128145 (Georgia)	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. Princess Clark allows following entities to bill medicare on her behalf.

Entity Name	Southeast Medical Group, P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235296054 PECOS PAC ID: 3577559673 Enrollment ID: O20040423000347

Entity Name	Utm Of Georgia Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255893038 PECOS PAC ID: 5991138307 Enrollment ID: O20191125002037

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. Princess 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
Princess Clark, APRN Po Box 80883, Athens, GA 30608-0883 Ph: (706) 549-8114	Princess Clark, APRN 3905 Brookside Pkwy Ste 300, Alpharetta, GA 30022-4458 Ph: (770) 442-1911

Reviews and Comments

Nurse Practitioner Nurses in Alpharetta, GA

Kathleen Marie Sklivagkos, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2710 Old Milton Pkwy Ste 150, Alpharetta, GA 30009 Phone: 770-274-9511
Mr. Terrance B Henderson, AGNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3180 N Point Pkwy Ste 302, Alpharetta, GA 30005 Phone: 404-800-5181
Karen Elizabeth Dunmire, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3795 Mansell Rd, Alpharetta, GA 30022 Phone: 404-785-8540 Fax: 404-785-8574
Amy Labib, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3180 N Point Pkwy, Alpharetta, GA 30005 Phone: 678-224-8686
Julia Weirbach, AGNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 960 N Point Pkwy Ste 120, Alpharetta, GA 30005 Phone: 770-800-3353
Regan J Kudlata, RN FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3400 Old Milton Pkwy # C, Ste 190, Alpharetta, GA 30005 Phone: 404-832-0300
Joanna M Huff, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 44 Milton Ave, Alpharetta, GA 30009 Phone: 425-449-1571

Princess Clark, APRN - Medicare Nurse Practitioner in Alpharetta, GA