Jeremy Clark, CRNP in Birmingham, AL - Medicare Nurse Practitioner

Jeremy Clark, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Birmingham, Alabama. His current practice location is 810 Saint Vincents Dr, Birmingham, Alabama. You can reach out to his office (for appointments etc.) via phone at (904) 372-3943.

Jeremy Clark is licensed to practice in Alabama (license number 1-178487) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1699458935.

Contact Information

	Jeremy Clark, CRNP
	810 Saint Vincents Dr, Birmingham, AL 35205-1601
	(904) 372-3943
	(904) 212-1618

Map and Direction

Provider's Profile

Full Name	Jeremy Clark
Gender	Male
Speciality	Nurse Practitioner - Family
Location	810 Saint Vincents Dr, Birmingham, Alabama
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1699458935
Provider Enumeration Date: 08/14/2023
Last Update Date: 10/02/2024

Medicare PECOS Information:

PECOS PAC ID: 9830544147
Enrollment ID: I20231005003420

Medical Identifiers

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

Identifier	Type	State	Issuer
1699458935	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	1-178487 (Alabama)	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. Jeremy Clark allows following entities to bill medicare on his behalf.

Entity Name	Pell City Internal Medicine Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649539610 PECOS PAC ID: 0648426825 Enrollment ID: O20120802000650

Entity Name	Diabetes Management Partners Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013461193 PECOS PAC ID: 9436435385 Enrollment ID: O20180515003077

Entity Name	Alabama Physicians Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750062527 PECOS PAC ID: 2668835604 Enrollment ID: O20230824000442

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. Jeremy 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
Jeremy Clark, CRNP 7751 Belfort Pkwy Ste 120, Jacksonville, FL 32256-6921 Ph: (904) 372-3943	Jeremy Clark, CRNP 810 Saint Vincents Dr, Birmingham, AL 35205-1601 Ph: (904) 372-3943

Reviews and Comments

Nurse Practitioner Nurses in Birmingham, AL

Mrs. April Hooper Weatherly, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1600 7th Ave S, Birmingham, AL 35233 Phone: 205-939-9175
Miss Leigh Anne Wenzel, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 800 Saint Vincents Dr, Suite500, Birmingham, AL 35205 Phone: 205-933-8334 Fax: 205-271-5681
Ms. Carly Rae Hawkins, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 7th Ave S, Birmingham, AL 35233 Phone: 205-638-9285 Fax: 205-975-1941
Ashlee Brooke Quick, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3729 Mary Taylor Rd, Birmingham, AL 35235 Phone: 205-856-4440 Fax: 205-856-4445
Anyet Belyeu, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1201 11th Ave S, Birmingham, AL 35205 Phone: 205-930-7155 Fax: 205-930-7061
Amy Urban, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 7th Ave S, Lowder Bldg., Suite 618, Birmingham, AL 35233 Phone: 205-638-9918
Jessica Cha, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1717 6th Ave S, Birmingham, AL 35233 Phone: 800-822-8816

Jeremy Clark, CRNP - Medicare Nurse Practitioner in Birmingham, AL