Whitney Nicole Clark, CNM - Medicare Certified Nurse Midwife (cnm) in Saint Marys, OH

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Whitney Nicole Clark, CNM is a medicare enrolled "Advanced Practice Midwife" in Saint Marys, Ohio. She graduated from nursing school in 2018 and has 7 years of diverse experience with area of expertise as Certified Nurse Midwife (cnm). She is a member of the group practice Jtdm Family Practice Llc and her current practice location is 1140 S Knoxville Ave Ste B, Saint Marys, Ohio. You can reach out to her office (for appointments etc.) via phone at (419) 394-7314.

Whitney Nicole Clark is licensed to practice in Ohio (license number APRN.CNM.019373) 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 1033605431.

Contact Information

Whitney Nicole Clark, CNM
1140 S Knoxville Ave Ste B,
Saint Marys, OH 45885-2609
(419) 394-7314
(419) 394-7313

Map and Direction




Provider's Profile

Full NameWhitney Nicole Clark
GenderFemale
SpecialityCertified Nurse Midwife (cnm)
Experience7 Years
Location1140 S Knoxville Ave Ste B, Saint Marys, Ohio
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:
  • Whitney Nicole Clark graduated from nursing school in 2018
  NPI Data:
  • NPI Number: 1033605431
  • Provider Enumeration Date: 07/09/2018
  • Last Update Date: 07/28/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5193072908
  • Enrollment ID: I20180725002674

Medical Identifiers

Medical identifiers for Whitney Nicole Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033605431NPI-NPPES
0300634MedicaidOH

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367A00000XAdvanced Practice Midwife APRN.CNM.019373 (Ohio)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Grand Lake Health SystemSaint marys, OHHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Jtdm Family Practice Llc216341583743

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. Whitney Nicole Clark allows following entities to bill medicare on her behalf.
Entity NameJtdm Family Practice Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184652539
PECOS PAC ID: 2163415837
Enrollment ID: O20040407000863
Entity NameKettering Independent Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629387865
PECOS PAC ID: 3173710936
Enrollment ID: O20101207000425

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. Whitney 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 AddressPractice Location Address
Whitney Nicole Clark, CNM
1140 S Knoxville Ave Ste D,
Saint Marys, OH 45885-2609

Ph: (419) 300-1129		Whitney Nicole Clark, CNM
1140 S Knoxville Ave Ste B,
Saint Marys, OH 45885-2609

Ph: (419) 394-7314

Reviews and Comments


Advanced Practice Midwife Nurses in Saint Marys, OH

Bridget E Heckler, CNM
Advanced Practice Midwife
Medicare: Accepting Medicare Assignments
Practice Location: 1140 S Knoxville Ave Ste B, Saint Marys, OH 45885
Phone: 419-394-7314    Fax: 419-394-7313
Brittani Skelton, CNM
Advanced Practice Midwife
Medicare: Not Enrolled in Medicare
Practice Location: 1140 S Knoxville Ave Ste B, Saint Marys, OH 45885
Phone: 419-394-7314    

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.