Dominique Clark, FNP-C in Cordova, TN - Medicare Nurse Practitioner

Dominique Clark, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Cordova, Tennessee. She graduated from nursing school in 2019 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Fast Pace Medical Clinic Pllc and her current practice location is 1540 Appling Care Ln, Cordova, Tennessee. You can reach out to her office (for appointments etc.) via phone at (901) 444-3950.

Dominique Clark is licensed to practice in Tennessee (license number 27344) 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 1346874716.

Contact Information

	Dominique Clark, FNP-C
	1540 Appling Care Ln, Cordova, TN 38016-4957
	(901) 444-3950
	Not Available

Map and Direction

Provider's Profile

Full Name	Dominique Clark
Gender	Female
Speciality	Nurse Practitioner
Experience	7 Years
Location	1540 Appling Care Ln, Cordova, Tennessee
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:

Dominique Clark graduated from nursing school in 2019

NPI Data:

NPI Number: 1346874716
Provider Enumeration Date: 02/25/2020
Last Update Date: 11/13/2020

Medicare PECOS Information:

PECOS PAC ID: 6608291687
Enrollment ID: I20200807001732

Medical Identifiers

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

Identifier	Type	State	Issuer
1346874716	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WE0003X	Registered Nurse - Emergency	174756 (Tennessee)	Secondary
363LF0000X	Nurse Practitioner - Family	27344 (Tennessee)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Fast Pace Medical Clinic Pllc	5395881841	680

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. Dominique Clark allows following entities to bill medicare on her behalf.

Entity Name	Fast Pace Medical Clinic Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134452865 PECOS PAC ID: 5395881841 Enrollment ID: O20091014000112

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. Dominique 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
Dominique Clark, FNP-C 1540 Appling Care Ln Ste 105, Cordova, TN 38016-4947 Ph: (901) 444-3970	Dominique Clark, FNP-C 1540 Appling Care Ln, Cordova, TN 38016-4957 Ph: (901) 444-3950

Reviews and Comments

Nurse Practitioner Nurses in Cordova, TN

Chandler Roberts Cummins, DNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 57 Germantown Ct Ste 100, Cordova, TN 38018 Phone: 901-763-0200
Mrs. Ashley Beth May, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 8132 Cordova Rd, Cordova, TN 38016 Phone: 901-405-6470 Fax: 901-747-2338
Paula M Martin, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1590 Bonnie Ln Ste 101, Cordova, TN 38016 Phone: 901-257-9060
Renee Wilson, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8000 Centerview Pkwy, Cordova, TN 38018 Phone: 888-852-1988
Ellen Lehman Mumaw, WHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1660 Bonnie Ln, Suite 105, Cordova, TN 38016 Phone: 901-888-1000
Mr. Corey Konemann, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 765 Woodland Trace Ln, Cordova, TN 38018 Phone: 888-851-2538
Dr. Camillia Haddix, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 65 Germantown Ct Ste 402, Cordova, TN 38018 Phone: 901-752-4900 Fax: 901-752-4902

Dominique Clark, FNP-C - Medicare Nurse Practitioner in Cordova, TN