Mr Kelly O'brian Clark, RN, MSN, FNP in Knox, IN

Mr Kelly O'brian Clark, RN, MSN, FNP is a medicare enrolled "Nurse Practitioner - Adult Health" in Knox, Indiana. He graduated from nursing school in 1996 and has 29 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Laporte County Comprehensive Mental Health Council and his current practice location is 1002 S Edgewood Dr, Knox, Indiana. You can reach out to his office (for appointments etc.) via phone at (574) 772-6030.

Mr Kelly O'brian Clark is licensed to practice in Indiana (license number 71000435A) 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 1811086903.

Contact Information

	Mr Kelly O'brian Clark, RN, MSN, FNP
	1002 S Edgewood Dr, Knox, IN 46534-8226
	(574) 772-6030
	(574) 772-7494

Map and Direction

Provider's Profile

Full Name	Mr Kelly O'brian Clark
Gender	Male
Speciality	Nurse Practitioner
Experience	29 Years
Location	1002 S Edgewood Dr, Knox, Indiana
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:

Mr Kelly O'brian Clark graduated from nursing school in 1996

NPI Data:

NPI Number: 1811086903
Provider Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 0143416677
Enrollment ID: I20101123000995

Medical Identifiers

Medical identifiers for Mr Kelly O'brian Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811086903	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2200X	Nurse Practitioner - Adult Health	71000435A (Indiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
La Porte Hospital	La porte, IN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Laporte County Comprehensive Mental Health Council	3274703046	16

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. Mr Kelly O'brian Clark allows following entities to bill medicare on his behalf.

Entity Name	Laporte County Comprehensive Mental Health Council
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295746816 PECOS PAC ID: 3274703046 Enrollment ID: O20110906000052

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. Mr Kelly O'brian 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
Mr Kelly O'brian Clark, RN, MSN, FNP 1002 S Edgewood Dr, Knox, IN 46534-8226 Ph: (574) 772-6030	Mr Kelly O'brian Clark, RN, MSN, FNP 1002 S Edgewood Dr, Knox, IN 46534-8226 Ph: (574) 772-6030

Reviews and Comments

Nurse Practitioner Nurses in Knox, IN

Brooke V Butler, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 104 E Culver Rd, 106, Knox, IN 46534 Phone: 574-772-7400 Fax: 574-772-0299
Jennifer R Frasure, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 104 E Culver Rd Ste 102, Knox, IN 46534 Phone: 574-772-7918 Fax: 574-772-0894
Mrs. Lesley Amber Metts, MSN, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1002 S Edgewood Dr, Knox, IN 46534 Phone: 574-772-6030
Ms. Melissa M Ilg, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1001 S Edgewood Dr, Knox, IN 46534 Phone: 574-772-4040
Tiffany Marie Bowser, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 104 E Culver Rd Ste 102, Knox, IN 46534 Phone: 574-772-7918 Fax: 574-772-0894
Erin Duff, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 104 E Culver Rd Ste 102, Knox, IN 46534 Phone: 574-772-7918 Fax: 574-772-0894
Mrs. Renae Charlene Atkins, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 104 E Culver Rd Ste 106, Knox, IN 46534 Phone: 574-772-7400 Fax: 574-772-0299

Mr Kelly O'brian Clark, RN, MSN, FNP - Medicare Nurse Practitioner in Knox, IN