Mrs Nichole Lowery Clontz, AGNP in Charlotte, NC

Mrs Nichole Lowery Clontz, AGNP is a medicare enrolled "Nurse Practitioner" in Charlotte, North Carolina. Her current practice location is 2616 E 5th St, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 333-5165.

Mrs Nichole Lowery Clontz is licensed to practice in North Carolina (license number 5015868) 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 1912653742.

Contact Information

	Mrs Nichole Lowery Clontz, AGNP
	2616 E 5th St, Charlotte, NC 28204-4343
	(704) 333-5165
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Nichole Lowery Clontz
Gender	Female
Speciality	Nurse Practitioner
Location	2616 E 5th St, Charlotte, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1912653742
Provider Enumeration Date: 03/02/2022
Last Update Date: 03/02/2022

Medicare PECOS Information:

PECOS PAC ID: 0345636783
Enrollment ID: I20220411002485

Medical Identifiers

Medical identifiers for Mrs Nichole Lowery Clontz such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912653742	NPI	-	NPPES
5015868	Other	NC	STATE LICENSING

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	5015868 (North 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. Mrs Nichole Lowery Clontz allows following entities to bill medicare on her behalf.

Entity Name	Acts Signature Community Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306201652 PECOS PAC ID: 5092032284 Enrollment ID: O20160517001001

Entity Name	Eventus Wholehealth Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548759392 PECOS PAC ID: 6002169539 Enrollment ID: O20181030001281

Entity Name	Norris Medical Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396506028 PECOS PAC ID: 2668812231 Enrollment ID: O20240430001061

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 Nichole Lowery Clontz 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 Nichole Lowery Clontz, AGNP 8401 Medical Plaza Dr Ste 365, Charlotte, NC 28262-8700 Ph: (704) 944-0975	Mrs Nichole Lowery Clontz, AGNP 2616 E 5th St, Charlotte, NC 28204-4343 Ph: (704) 333-5165

Reviews and Comments

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Mrs Nichole Lowery Clontz, AGNP - Medicare Nurse Practitioner in Charlotte, NC