Mrs Crystal B Clark, FNP-C is a medicare enrolled "Family Medicine" in Lancaster, South Carolina. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Ohio Valley Physicians Inc and her current practice location is
114 S Main St, Lancaster, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 286-7555.
Mrs 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 | Mrs Crystal B Clark |
---|
Gender | Female |
---|
Speciality | Nurse Practitioner |
---|
Experience | 6 Years |
---|
Location | 114 S Main St, Lancaster, South Carolina |
---|
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mrs Crystal B Clark graduated from nursing school in 2018
NPI Data:
- NPI Number: 1154898179
- Provider Enumeration Date: 10/29/2018
- Last Update Date: 03/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 5193123727
- Enrollment ID: I20211012000795
Medical Identifiers
Medical identifiers for Mrs Crystal B Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1154898179 | NPI | - | NPPES |
NP5853 | Medicaid | SC | |
22378 | Other | SC | APRN LICENSURE |
5422378 | Other | SC | CONTROLLED SUBSTANCE LICENSURE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | 22378 (South Carolina) | Secondary |
363LA2100X | Nurse Practitioner - Acute Care | 22378 (South Carolina) | Secondary |
363LF0000X | Nurse Practitioner - Family | 22378 (South Carolina) | Secondary |
207Q00000X | Family Medicine | 22378 (South Carolina) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Ohio Valley Physicians Inc | 8729032966 | 111 |
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. Mrs Crystal B Clark allows following entities to bill medicare on her behalf.
Entity Name | Ohio Valley Physicians Inc |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1710418553 PECOS PAC ID: 8729032966 Enrollment ID: O20170519002001 |
---|
Entity Name | Ovp Health Care Inc |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1356954978 PECOS PAC ID: 0648694596 Enrollment ID: O20200916001512 |
---|
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. Mrs 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 |
Mrs Crystal B Clark, FNP-C 114 S Main St, Lancaster, SC 29720-2442 Ph: (803) 577-6026 | Mrs Crystal B Clark, FNP-C 114 S Main St, Lancaster, SC 29720-2442 Ph: (803) 286-7555 |
Reviews and Comments