Mrs Dakota Ellis Clark, FNP - Medicare Nurse Practitioner in Scottsboro, AL

Mrs Dakota Ellis Clark, FNP is a medicare enrolled "Nurse Practitioner - Family" in Scottsboro, Alabama. Her current practice location is 380 Woods Cove Rd, Scottsboro, Alabama. You can reach out to her office (for appointments etc.) via phone at (256) 218-3340.

Mrs Dakota Ellis Clark is licensed to practice in Alabama (license number 1-156690) 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 1033894043.

Contact Information

Mrs Dakota Ellis Clark, FNP
380 Woods Cove Rd,
Scottsboro, AL 35768-2428
(256) 218-3340
(256) 218-3655



Provider's Profile

Full NameMrs Dakota Ellis Clark
GenderFemale
SpecialityNurse Practitioner - Family
Location380 Woods Cove Rd, Scottsboro, Alabama
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1033894043
  • Provider Enumeration Date: 06/19/2023
  • Last Update Date: 06/19/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9638532047
  • Enrollment ID: I20230901001912

Medical Identifiers

Medical identifiers for Mrs Dakota Ellis Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033894043NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 1-156690 (Alabama)Primary

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. Mrs Dakota Ellis Clark allows following entities to bill medicare on her behalf.
Entity NameHighlands Professional Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750041786
PECOS PAC ID: 0648666198
Enrollment ID: O20220408001223

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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. Mrs Dakota Ellis 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
Mrs Dakota Ellis Clark, FNP
380 Woods Cove Rd,
Scottsboro, AL 35768-2428

Ph: (256) 218-3340
Mrs Dakota Ellis Clark, FNP
380 Woods Cove Rd,
Scottsboro, AL 35768-2428

Ph: (256) 218-3340

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Nurse Practitioner Nurses in Scottsboro, AL

Marla Byrum, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 412 W Cloverdale Rd, Scottsboro, AL 35768
Phone: 337-991-9276    
Mrs. Maura Owens Galvez, CRNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 23800 John T Reid Pkwy, Scottsboro, AL 35768
Phone: 256-999-0808    
Julie Elizabeth Johnson, CRNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 1601 Veterans Dr Ste 107, Scottsboro, AL 35769
Phone: 256-999-0337    Fax: 256-999-0335
Ms. Charis W Peek, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2207 Moody Ridge Rd, Scottsboro, AL 35768
Phone: 256-259-1327    
Claudette B Wygal, CRNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 505 Burlington St, Scottsboro, AL 35768
Phone: 256-259-4100    Fax: 256-259-4104
Mrs. Laura C Walls, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1508 S Broad St Ste 300, Scottsboro, AL 35768
Phone: 256-259-3600    Fax: 256-256-3601

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