Vivian Clark, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Nokesville, Virginia. Her current practice location is
11855 Parkgate Dr, Nokesville, Virginia. You can reach out to her office (for appointments etc.) via phone at
(571) 379-1228.
Vivian Clark is licensed to practice in Virginia (license number 0024189931) 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 1699528117.
Provider's Profile
| Full Name | Vivian Clark |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 11855 Parkgate Dr, Nokesville, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1699528117
- Provider Enumeration Date: 04/08/2024
- Last Update Date: 05/29/2024
Medicare PECOS Information:
- PECOS PAC ID: 6709323405
- Enrollment ID: I20240730004197
Medical Identifiers
Medical identifiers for Vivian Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1699528117 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 0024189931 (Virginia) | 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. Vivian Clark allows following entities to bill medicare on her behalf.
| Entity Name | Emergency Coverage Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1427005008
PECOS PAC ID: 3072412592
Enrollment ID: O20050418000414 |
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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. Vivian 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 |
|---|
Vivian Clark, FNP-BC
11855 Parkgate Dr,
Nokesville, VA 20181-2719
Ph: (571) 379-1228 | Vivian Clark, FNP-BC
11855 Parkgate Dr,
Nokesville, VA 20181-2719
Ph: (571) 379-1228 |
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