Clare Blake Clark, MS, CCC-SLP is a medicare enrolled "Speech-language Pathologist" provider in West Paducah, Kentucky. Her current practice location is
1155 Gholson Rd, West Paducah, Kentucky. You can reach out to her office (for appointments etc.) via phone at
(270) 210-3422.
Clare Blake Clark is licensed to practice in Kentucky (license number KY-2643) 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 1376675710.
Healthcare Provider's Profile
| Full Name | Clare Blake Clark |
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| Gender | Female |
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| Speciality | Speech-language Pathologist |
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| Location | 1155 Gholson Rd, West Paducah, Kentucky |
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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: 1376675710
- Provider Enumeration Date: 03/12/2007
- Last Update Date: 06/02/2020
Medicare PECOS Information:
- PECOS PAC ID: 8123270063
- Enrollment ID: I20121128000664
Medical Identifiers
Medical identifiers for Clare Blake Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1376675710 | NPI | - | NPPES |
| 1890 | Other | KY | FIRST STEPS PROVIDER-CBIS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 235Z00000X | Speech-language Pathologist | KY-2643 (Kentucky) | 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. Clare Blake Clark allows following entities to bill medicare on her behalf.
| Provider Name | Atlas Physical Therapy Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1063816940
PECOS PAC ID: 0941523245
Enrollment ID: O20141217001550 |
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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. Clare Blake 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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Clare Blake Clark, MS, CCC-SLP
1155 Gholson Rd,
West Paducah, KY 42086-9738
Ph: (270) 210-3422 | Clare Blake Clark, MS, CCC-SLP
1155 Gholson Rd,
West Paducah, KY 42086-9738
Ph: (270) 210-3422 |
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