Susan B Clark, MS, RD, LD, CDE is a medicare enrolled "Dietitian, Registered" provider in Rexburg, Idaho. Her current practice location is
450 E Main St, Rexburg, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 359-6522.
Susan B Clark is licensed to practice in Idaho (license number D-393) 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 1124676663.
Healthcare Provider's Profile
Full Name | Susan B Clark |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | 450 E Main St, Rexburg, Idaho |
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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. |
Medical Education and Training:
- Susan B Clark attended and graduated from in
NPI Data:
- NPI Number: 1124676663
- Provider Enumeration Date: 08/28/2019
- Last Update Date: 08/28/2019
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Susan B Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124676663 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | D-393 (Idaho) | Primary |
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. Susan B 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 |
Susan B Clark, MS, RD, LD, CDE 450 E Main St, Rexburg, ID 83440-2048 Ph: (208) 359-6522 | Susan B Clark, MS, RD, LD, CDE 450 E Main St, Rexburg, ID 83440-2048 Ph: (208) 359-6522 |
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