Miss Crystal B Clark, FNP-C is a medicare enrolled "Family Medicine" in Fort Mill, South Carolina. Her current practice location is
885 Gold Hill Rd # 1003, Fort Mill, 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
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1154898179.
Provider's Profile
| Full Name | Miss Crystal B Clark |
|---|
| Gender | Female |
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| Speciality | |
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| Experience | Years |
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| Location | 885 Gold Hill Rd # 1003, Fort Mill, South Carolina |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Miss Crystal B Clark attended and graduated from in
NPI Data:
- NPI Number: 1154898179
- Provider Enumeration Date: 10/29/2018
- Last Update Date: 09/28/2025
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
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 |
| 5422378 | Other | SC | CONTROLLED SUBSTANCE LICENSURE |
| 22378 | Other | SC | APRN LICENSURE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | 22378 (South Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 22378 (South Carolina) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 22378 (South Carolina) | Secondary |
| 207Q00000X | Family Medicine | 22378 (South Carolina) | Primary |
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
2223 Camp Creek Rd,
Lancaster, SC 29720-8511
Ph: (704) 292-3651 | Miss Crystal B Clark, FNP-C
885 Gold Hill Rd # 1003,
Fort Mill, SC 29708-7946
Ph: (803) 288-9495 |
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