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KERESSA L. CLARK NP NPI 1346693868


NPI Information

NPI: 1346693868
Provider Name: KERESSA L. CLARK, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
111 W STONE DR
SUITE 110
KINGSPORT, TN
ZIP 37660
Phone: (423) 224-3701
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Keressa L. Clark, NP is a family nurse practitioner in Kingsport, TN with 8 years of experience. Keressa L. Clark, NP NPI is 1346693868. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

111 W STONE DR
SUITE 110
KINGSPORT, TN
ZIP 37660-027
Phone: (423) 224-3701
Fax: (423) 224-3709

The NPI 1346693868 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Automated urinalysis test (HCPCS:81003)
  • Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Vaccine for influenza for injection into muscle (HCPCS:90662)

The enumeration date for this NPI number is 7/20/2016 and was last updated on 9/14/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamily0024173732VIRGINIANo
2363LF0000XNurse PractitionerFamily21571TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
110350I7991MEDICARE PINTENNESSEE
2VVL791B288MEDICARE PINVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.