Stephanie Nicole Clark, CRNA in Goldsboro, NC - Medicare Nurse Anesthetist, Certified Registered

Stephanie Nicole Clark, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Goldsboro, North Carolina. Her current practice location is 2700 Wayne Memorial Dr, Goldsboro, North Carolina. You can reach out to her office (for appointments etc.) via phone at (919) 731-6068.

Stephanie Nicole Clark is licensed to practice in Mississippi (license number 901448) 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 1215486444.

Contact Information

	Stephanie Nicole Clark, CRNA
	2700 Wayne Memorial Dr, Goldsboro, NC 27534-9494
	(919) 731-6068
	(919) 731-6025

Map and Direction

Provider's Profile

Full Name	Stephanie Nicole Clark
Gender	Female
Speciality	Nurse Anesthetist, Certified Registered
Location	2700 Wayne Memorial Dr, Goldsboro, 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: 1215486444
Provider Enumeration Date: 09/29/2016
Last Update Date: 10/02/2018

Medicare PECOS Information:

PECOS PAC ID: 3779862933
Enrollment ID: I20161111000796

Medical Identifiers

Medical identifiers for Stephanie Nicole Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215486444	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	901448 (Mississippi)	Primary
367500000X	Nurse Anesthetist, Certified Registered	111055 (Alabama)	Secondary

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. Stephanie Nicole Clark allows following entities to bill medicare on her behalf.

Entity Name	Wayne Memorial Hospital Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750353462 PECOS PAC ID: 3971409079 Enrollment ID: O20070412000518

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. Stephanie Nicole 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
Stephanie Nicole Clark, CRNA 105 Katherine Dr, Ste G, Flowood, MS 39232-8857 Ph: (919) 731-6068	Stephanie Nicole Clark, CRNA 2700 Wayne Memorial Dr, Goldsboro, NC 27534-9494 Ph: (919) 731-6068

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Goldsboro, NC

Mr. Richard Joseph Bazik, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2700 Wayne Memorial Drive, Goldsboro, NC 27534 Phone: 919-731-6068 Fax: 919-731-6025
Mrs. Paula Gryder Jarman, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2700 Wayne Memorial Drive, Goldsboro, NC 27534 Phone: 919-731-0668 Fax: 919-731-6025
Mr. Robert Gerald White Jr., CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2700 Wayne Memorial Drive, Goldsboro, NC 27534 Phone: 919-731-6068 Fax: 919-731-6025
Mrs. Angela Britt Whitten, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2700 Wayne Memorial Dr, Goldsboro, NC 27534 Phone: 919-731-6065
Ms. Jamie Harrell Richards, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2700 Wayne Memorial Drive, Goldsboro, NC 27534 Phone: 919-731-6068 Fax: 919-731-6025
Dr. Anissa Sheree Breland, DNP, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2700 Wayne Memorial Drive, Goldsboro, NC 27534 Phone: 919-736-1110

Stephanie Nicole Clark, CRNA - Medicare Nurse Anesthetist, Certified Registered in Goldsboro, NC