Katherine Sue Clark, APRN is a medicare enrolled "Nurse Practitioner - Family" in Stokesdale, North Carolina. She graduated from nursing school in 2022 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Qsm-ga, Inc and her current practice location is
7700 Us Highway 158, Stokesdale, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(800) 226-8874.
Katherine Sue Clark is licensed to practice in North Carolina (license number 501887) 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 1376220798.
Provider's Profile
| Full Name | Katherine Sue Clark |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 7700 Us Highway 158, Stokesdale, North Carolina |
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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. |
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Medical Education and Training:
- Katherine Sue Clark graduated from nursing school in 2022
NPI Data:
- NPI Number: 1376220798
- Provider Enumeration Date: 06/28/2023
- Last Update Date: 01/29/2024
Medicare PECOS Information:
- PECOS PAC ID: 9436504867
- Enrollment ID: I20231030003211
Medical Identifiers
Medical identifiers for Katherine Sue Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1376220798 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | APRN11023419 (Florida) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | GAA-NP001335 (Georgia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 501887 (North Carolina) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Qsm-ga, Inc | 3779842729 | 12 |
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. Katherine Sue Clark allows following entities to bill medicare on her behalf.
| Entity Name | Qsm-ga, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356852123
PECOS PAC ID: 3779842729
Enrollment ID: O20180119000529 |
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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. Katherine Sue 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 |
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Katherine Sue Clark, APRN
3791 S Cranberry Blvd,
North Port, FL 34286-4310
Ph: (941) 266-3681 | Katherine Sue Clark, APRN
7700 Us Highway 158,
Stokesdale, NC 27357-9346
Ph: (800) 226-8874 |
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