Kelsey Leigh-ann Clark, CRNP in Moulton, AL - Medicare Nurse Practitioner

Kelsey Leigh-ann Clark, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Moulton, Alabama. Her current practice location is 12461 Al Highway 157, Moulton, Alabama. You can reach out to her office (for appointments etc.) via phone at (256) 444-6210.

Kelsey Leigh-ann Clark is licensed to practice in Alabama (license number 1-150045) 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 1063010312.

Contact Information

	Kelsey Leigh-ann Clark, CRNP
	12461 Al Highway 157, Moulton, AL 35650-1063
	(256) 444-6210
	(256) 444-6211

Map and Direction

Provider's Profile

Full Name	Kelsey Leigh-ann Clark
Gender	Female
Speciality	Nurse Practitioner - Family
Location	12461 Al Highway 157, Moulton, Alabama
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063010312
Provider Enumeration Date: 10/09/2020
Last Update Date: 06/24/2025

Medicare PECOS Information:

PECOS PAC ID: 4284054719
Enrollment ID: I20201021002203

Medical Identifiers

Medical identifiers for Kelsey Leigh-ann Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063010312	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	1-150045 (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. Kelsey Leigh-ann Clark allows following entities to bill medicare on her behalf.

Entity Name	Alabama Urology And Robotics Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114138104 PECOS PAC ID: 7214961481 Enrollment ID: O20050927000312

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. Kelsey Leigh-ann 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
Kelsey Leigh-ann Clark, CRNP 12461 Al Highway 157, Moulton, AL 35650-1063 Ph: (256) 444-6210	Kelsey Leigh-ann Clark, CRNP 12461 Al Highway 157, Moulton, AL 35650-1063 Ph: (256) 444-6210

Reviews and Comments

Nurse Practitioner Nurses in Moulton, AL

Mrs. Kari Kirby, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 94 Medical Cir, Moulton, AL 35650 Phone: 256-974-9216
Jamie Rose Ghrigsby, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 122 Medical Cir, Moulton, AL 35650 Phone: 256-410-3544 Fax: 256-410-3644
Earrace Morris, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 40 Medical Cir, Moulton, AL 35650 Phone: 256-974-0606 Fax: 256-522-2226
Charity Elizabeth Smith, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12490 Al Highway 157, Moulton, AL 35650 Phone: 256-284-7706
Kristen Holly Espy, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 10939 Al Highway 157, Moulton, AL 35650 Phone: 256-974-6550
Mrs. Wyndie Watson White, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 10939 Al Highway 157, Moulton, AL 35650 Phone: 256-974-3390

Kelsey Leigh-ann Clark, CRNP - Medicare Nurse Practitioner in Moulton, AL