Mark D Clark, FNP in Gainesville, GA - Medicare Nurse Practitioner

Mark D Clark, FNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Gainesville, Georgia. He graduated from nursing school in 2001 and has 24 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Northeast Georgia Diagnostic Associates And Clinic, Llc and his current practice location is 102 Barrett St, Gainesville, Georgia. You can reach out to his office (for appointments etc.) via phone at (770) 540-4274.

Mark D Clark is licensed to practice in Georgia (license number RN128712) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1285631887.

Contact Information

	Mark D Clark, FNP
	102 Barrett St, Gainesville, GA 30501-1356
	(770) 540-4274
	Not Available

Map and Direction

Provider's Profile

Full Name	Mark D Clark
Gender	Male
Speciality	Nurse Practitioner
Experience	24 Years
Location	102 Barrett St, Gainesville, Georgia
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mark D Clark graduated from nursing school in 2001

NPI Data:

NPI Number: 1285631887
Provider Enumeration Date: 06/29/2005
Last Update Date: 02/05/2021

Medicare PECOS Information:

PECOS PAC ID: 2961479324
Enrollment ID: I20040914001333

Medical Identifiers

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

Identifier	Type	State	Issuer
1285631887	NPI	-	NPPES
1738523	Other	GA	WELLCARE
06423272	Other	GA	AMERIGROUP
615230572C	Medicaid	GA
615230572E	Medicaid	GA
615230572F	Medicaid	GA
615230572D	Medicaid	GA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	RN128712 (Georgia)	Secondary
363LA2200X	Nurse Practitioner - Adult Health	RN128712 (Georgia)	Secondary
363LG0600X	Nurse Practitioner - Gerontology	RN128712 (Georgia)	Secondary
363LA2100X	Nurse Practitioner - Acute Care	RN128712 (Georgia)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Northeast Georgia Diagnostic Associates And Clinic, Llc	1951655737	80

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. Mark D Clark allows following entities to bill medicare on his behalf.

Entity Name	Northeast Georgia Diagnostic Associates And Clinic, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144719311 PECOS PAC ID: 1951655737 Enrollment ID: O20181114000949

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. Mark D 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
Mark D Clark, FNP 102 Barrett St, Gainesville, GA 30501-1356 Ph: (770) 540-4274	Mark D Clark, FNP 102 Barrett St, Gainesville, GA 30501-1356 Ph: (770) 540-4274

Reviews and Comments

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Mark D Clark, FNP - Medicare Nurse Practitioner in Gainesville, GA