Dr Richard Gary Clark, MD is a medicare enrolled "Internal Medicine" physician in Jamestown, Tennessee. He went to University Of Tennessee, Hsc, College Of Medicine and graduated in 1977 and has 48 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Acute Care Clinics Of America, Llc and his current practice location is
100 S Duncan St, Jamestown, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(931) 879-5864.
Dr Richard Gary Clark is licensed to practice in Tennessee (license number 11080) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1962406793.
Physician's Profile
| Full Name | Dr Richard Gary Clark |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Experience | 48 Years |
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| Location | 100 S Duncan St, Jamestown, Tennessee |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Richard Gary Clark attended and graduated from University Of Tennessee, Hsc, College Of Medicine in 1977
NPI Data:
- NPI Number: 1962406793
- Provider Enumeration Date: 06/09/2005
- Last Update Date: 03/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 8123157971
- Enrollment ID: I20100603000658
Medical Identifiers
Medical identifiers for Dr Richard Gary Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962406793 | NPI | - | NPPES |
| 4053283 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 11080 (Tennessee) | Secondary |
| 208M00000X | Hospitalist | 11080 (Tennessee) | Secondary |
| 207R00000X | Internal Medicine | 11080 (Tennessee) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Acute Care Clinics Of America, Llc | 6305273392 | 6 |
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. Dr Richard Gary Clark allows following entities to bill medicare on his behalf.
| Entity Name | Acute Care Clinics Of America, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1780235564
PECOS PAC ID: 6305273392
Enrollment ID: O20200304001675 |
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| Entity Name | Monterey Medical Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1497339790
PECOS PAC ID: 7012316961
Enrollment ID: O20210811003455 |
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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. Dr Richard Gary 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 |
|---|
Dr Richard Gary Clark, MD
Po Box 2861,
Crossville, TN 38557-2861
Ph: (931) 879-5864 | Dr Richard Gary Clark, MD
100 S Duncan St,
Jamestown, TN 38556-3009
Ph: (931) 879-5864 |
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