Delores L Clark, CRNA in Charlotte, NC - Medicare Nurse Anesthetist, Certified Registered

Delores L Clark, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Charlotte, North Carolina. Her current practice location is 200 Hawthorne Lane, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 384-4239.

Delores L Clark is licensed to practice in North Carolina (license number 044078) 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 1932157039.

Contact Information

	Delores L Clark, CRNA
	200 Hawthorne Lane, Charlotte, NC 28204
	(704) 384-4239
	(704) 384-5636

Map and Direction

Provider's Profile

Full Name	Delores L Clark
Gender	Female
Speciality	Nurse Anesthetist, Certified Registered
Location	200 Hawthorne Lane, Charlotte, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932157039
Provider Enumeration Date: 05/04/2006
Last Update Date: 12/13/2010

Medicare PECOS Information:

PECOS PAC ID: 6507054467
Enrollment ID: I20101220001032

Medical Identifiers

Medical identifiers for Delores L Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932157039	NPI	-	NPPES
NAN107	Medicaid	SC
8050810	Medicaid	NC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	044078 (North Carolina)	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. Delores L Clark allows following entities to bill medicare on her behalf.

Entity Name	The Presbyterian Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487626933 PECOS PAC ID: 1153231907 Enrollment ID: O20031126000588

Entity Name	Coastal Healthcare Resources Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1467635128 PECOS PAC ID: 1658283593 Enrollment ID: O20090929000052

Entity Name	Nmg Southpark Services, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952690109 PECOS PAC ID: 6901075977 Enrollment ID: O20110808000705

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. Delores L 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
Delores L Clark, CRNA Po Box 601549, Charlotte, NC 28260-1549 Ph: () -	Delores L Clark, CRNA 200 Hawthorne Lane, Charlotte, NC 28204 Ph: (704) 384-4239

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Charlotte, NC

Welo Sylvie Olenga, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 200 Hawthorne Ln, Charlotte, NC 28204 Phone: 704-384-4239 Fax: 704-384-5636
Alexandru Daniel Vlasin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-2000
Mr. Kevin E. West, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-8983 Fax: 704-355-8994
Mrs. Colleen M. Ebner, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-8983 Fax: 704-355-8994
Mrs. Christine E. Jones, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-8983 Fax: 704-355-8994
Meredith L Draper, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-2000
Alison Anne Woodruff, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-2000

Delores L Clark, CRNA - Medicare Nurse Anesthetist, Certified Registered in Charlotte, NC