Miss Crystal B Clark, FNP-C is a medicare enrolled "Family Medicine" in Pageland, South Carolina. Her current practice location is
211 S Pearl St Ste B, Pageland, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 288-9495.
Miss Crystal B Clark is licensed to practice in South Carolina (license number 22378) 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 1154898179.
Provider's Profile
| Full Name | Miss Crystal B Clark |
|---|
| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 211 S Pearl St Ste B, Pageland, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1154898179
- Provider Enumeration Date: 10/29/2018
- Last Update Date: 07/23/2026
Medicare PECOS Information:
- PECOS PAC ID: 5193123727
- Enrollment ID: I20211012000795
Medical Identifiers
Medical identifiers for Miss Crystal B Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154898179 | NPI | - | NPPES |
| 22378 | Other | SC | APRN LICENSURE |
| NP5853 | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | 22378 (South Carolina) | Secondary |
| 207Q00000X | Family Medicine | 22378 (South Carolina) | 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. Miss Crystal B Clark allows following entities to bill medicare on her behalf.
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. Miss Crystal B 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 |
|---|
Miss Crystal B Clark, FNP-C
211 S Pearl St Ste B,
Pageland, SC 29728-2261
Ph: (843) 675-5070 | Miss Crystal B Clark, FNP-C
211 S Pearl St Ste B,
Pageland, SC 29728-2261
Ph: (803) 288-9495 |
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