Miranda Clark, FNP in Millington, TN - Medicare Nurse Practitioner

Miranda Clark, FNP is a medicare enrolled "Nurse Practitioner - Family" in Millington, Tennessee. Her current practice location is 4772 Navy Rd Ste A, Millington, Tennessee. You can reach out to her office (for appointments etc.) via phone at (901) 873-0930.

Miranda Clark is licensed to practice in Tennessee (license number 29697) 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 1407528722.

Contact Information

	Miranda Clark, FNP
	4772 Navy Rd Ste A, Millington, TN 38053-1927
	(901) 873-0930
	(901) 873-0931

Map and Direction

Provider's Profile

Full Name	Miranda Clark
Gender	Female
Speciality	Nurse Practitioner - Family
Location	4772 Navy Rd Ste A, Millington, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1407528722
Provider Enumeration Date: 10/05/2021
Last Update Date: 07/20/2023

Medicare PECOS Information:

PECOS PAC ID: 9537558945
Enrollment ID: I20211104002929

Medical Identifiers

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

Identifier	Type	State	Issuer
1407528722	NPI	-	NPPES
95021208	Other	CA	CALIFORNIA BOARD OF REGISTERED NURSING

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	29697 (Tennessee)	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. Miranda Clark allows following entities to bill medicare on her behalf.

Entity Name	Hamad Ahmad Md Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588116891 PECOS PAC ID: 0749553816 Enrollment ID: O20170912001785

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. Miranda 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
Miranda Clark, FNP 3243 Cypress Rd, Memphis, TN 38128-6103 Ph: () -	Miranda Clark, FNP 4772 Navy Rd Ste A, Millington, TN 38053-1927 Ph: (901) 873-0930

Reviews and Comments

Nurse Practitioner Nurses in Millington, TN

Marde M Walker, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8225 Highway 51 North, Millington, TN 38053 Phone: 901-222-9948
Sharon Moore, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8081 Us Highway 51 N, Millington, TN 38053 Phone: 901-873-4194 Fax: 901-347-1333
Erica Anderson, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4772 Navy Rd Ste A, Millington, TN 38053 Phone: 901-873-0930 Fax: 901-873-0931
Karen P Williams, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4772 Navy Rd Ste A, Millington, TN 38053 Phone: 901-873-0930 Fax: 901-873-0931
Mrs. Elaina Cubine Hogan, PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Primary Care Pediatrics, 8222 Hwy 51 N, Millington, TN 38053 Phone: 901-873-4242 Fax: 901-873-4269
Janelle Marie Scullark, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4772 Navy Rd, Millington, TN 38053 Phone: 901-333-3333
Mrs. Leellon Louise Martin, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5831 Port Haven Rd, Millington, TN 38053 Phone: 901-849-4108

Miranda Clark, FNP - Medicare Nurse Practitioner in Millington, TN