Rhonda Iddins Clark, FNP is a medicare enrolled "Nurse Practitioner - Family" in Needles, California. She went to East Tennessee State University Quillen College Of Medicine and graduated in 2013 and has 13 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Lakeside Orthopedic Institute Llc and her current practice location is
1402 Bailey Ave, Needles, California. You can reach out to her office (for appointments etc.) via phone at
(760) 326-0222.
Rhonda Iddins Clark is licensed to practice in California (license number 95006850) 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 1528486172.
Provider's Profile
| Full Name | Rhonda Iddins Clark |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 13 Years |
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| Location | 1402 Bailey Ave, Needles, California |
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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:
- Rhonda Iddins Clark attended and graduated from East Tennessee State University Quillen College Of Medicine in 2013
NPI Data:
- NPI Number: 1528486172
- Provider Enumeration Date: 04/01/2014
- Last Update Date: 04/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 1052538493
- Enrollment ID: I20210628003166
Medical Identifiers
Medical identifiers for Rhonda Iddins Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1528486172 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 18691 (Tennessee) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 3009621 (Kentucky) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 240243 (Arizona) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 95006850 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Lakeside Orthopedic Institute Llc | 1052316445 | 21 |
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. Rhonda Iddins Clark allows following entities to bill medicare on her behalf.
| Entity Name | Lakeside Orthopedic Institute Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275564916
PECOS PAC ID: 1052316445
Enrollment ID: O20060918000307 |
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| Entity Name | Nextcare Arizona Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043371826
PECOS PAC ID: 9537161260
Enrollment ID: O20070209000357 |
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| Entity Name | Tri-state Community Healthcare Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1841703253
PECOS PAC ID: 5597991968
Enrollment ID: O20200603000665 |
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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. Rhonda Iddins 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 |
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Rhonda Iddins Clark, FNP
1402 Bailey Ave,
Needles, CA 92363-3104
Ph: (760) 326-0222 | Rhonda Iddins Clark, FNP
1402 Bailey Ave,
Needles, CA 92363-3104
Ph: (760) 326-0222 |
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