Nadia Shanise Clark, FNP-C - Medicare Nurse Practitioner in Hattiesburg, MS

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Nadia Shanise Clark, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Hattiesburg, Mississippi. She graduated from nursing school in 2021 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Fast Pace Mississippi Pllc, Covington County Hospital and her current practice location is 5056 W 4th St # 100, Hattiesburg, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 446-2056.

Nadia Shanise Clark is licensed to practice in Mississippi (license number 904907) 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 1689345506.

Contact Information

Nadia Shanise Clark, FNP-C
5056 W 4th St # 100,
Hattiesburg, MS 39402-1069
(601) 446-2056
(949) 288-0396

Map and Direction




Provider's Profile

Full NameNadia Shanise Clark
GenderFemale
SpecialityNurse Practitioner
Experience4 Years
Location5056 W 4th St # 100, Hattiesburg, Mississippi
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Nadia Shanise Clark graduated from nursing school in 2021
  NPI Data:
  • NPI Number: 1689345506
  • Provider Enumeration Date: 09/21/2021
  • Last Update Date: 05/21/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 3870987787
  • Enrollment ID: I20220218000291

Medical Identifiers

Medical identifiers for Nadia Shanise Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689345506NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 904907 (Mississippi)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Covington County Hospital CahCollins, MSHospital

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. Nadia Shanise Clark allows following entities to bill medicare on her behalf.
Entity NameCovington County Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518260330
PECOS PAC ID: 4183517253
Enrollment ID: O20040203000816
Entity NameCovington County Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598769044
PECOS PAC ID: 4183517253
Enrollment ID: O20080722000557
Entity NamePioneer Health Care , Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336384742
PECOS PAC ID: 4789740044
Enrollment ID: O20090311000659
Entity NameCovington County Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134435498
PECOS PAC ID: 4183517253
Enrollment ID: O20110413000929
Entity NameCovington County Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336447861
PECOS PAC ID: 4183517253
Enrollment ID: O20110519000619
Entity NameFast Pace Mississippi Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447769559
PECOS PAC ID: 3678832029
Enrollment ID: O20180111000291
Entity NameCovington County Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750895611
PECOS PAC ID: 4183517253
Enrollment ID: O20190517001731
Entity NameCovington County Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1306460282
PECOS PAC ID: 4183517253
Enrollment ID: O20201103000549
Entity NameByron Kemp Clark
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871392860
PECOS PAC ID: 5395263586
Enrollment ID: O20250521000478

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. Nadia Shanise 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 AddressPractice Location Address
Nadia Shanise Clark, FNP-C
8 Sequatchie,
Hattiesburg, MS 39402-1269

Ph: (601) 410-7189		Nadia Shanise Clark, FNP-C
5056 W 4th St # 100,
Hattiesburg, MS 39402-1069

Ph: (601) 446-2056

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.