Rhonda Iddins Clark, FNP is a medicare enrolled "Nurse Practitioner - Family" in Needles, California. Her current practice location is
1402 Bailey Ave, Needles, California. You can reach out to her office (for appointments etc.) via phone at
(760) 326-0222.
Rhonda Iddins Clark is licensed to practice in California (license number 95006850) 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 1528486172.
Provider's Profile
| Full Name | Rhonda Iddins Clark |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 1402 Bailey Ave, Needles, California |
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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: 1528486172
- Provider Enumeration Date: 04/01/2014
- Last Update Date: 04/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 1052538493
- Enrollment ID: I20140808001121
Medical Identifiers
Medical identifiers for Rhonda Iddins Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1528486172 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 18691 (Tennessee) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 3009621 (Kentucky) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 240243 (Arizona) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 95006850 (California) | 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. Rhonda Iddins Clark allows following entities to bill medicare on her behalf.
| Entity Name | Summit Medical Group, Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659090298
PECOS PAC ID: 2860396330
Enrollment ID: O20031125000793 |
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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. Rhonda Iddins 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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Rhonda Iddins Clark, FNP
1402 Bailey Ave,
Needles, CA 92363-3104
Ph: (760) 326-0222 | Rhonda Iddins Clark, FNP
1402 Bailey Ave,
Needles, CA 92363-3104
Ph: (760) 326-0222 |
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