SHALITA CLARK (CRNP) – Psychiatry Physician, NPI 1396214060
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,653 NURSE PRACTITIONER in AL
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Provider Addresses for SHALITA CLARK (CRNP)
120, Fairlane Drive, Pleasant Grove, Jefferson County, Alabama, 35127, United States
PLEASANT GROVE, AL 351272741
Phone: (205) 936-0429
Type: Mailing
Southeast Health Campus, 1108, Ross Clark Circle, Morris Heights, Dothan, Houston County, Alabama, 36301, United States
DOTHAN, AL 363013022
Phone: (334) 712-3635
Fax: (334) 699-4387
Type: Location
234 E 149TH ST
BRONX, NY 104515589
Phone: (718) 579-5006
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $1,092.
Total Amount is formed as General ($1,092) + Research ($0) + Ownership ($0) = $1,092.
Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($240).
Total Amount
$1,092
General + Research + Ownership
Payments
10
Total payment records
General Amount
$1,092
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Teva Pharmaceuticals USA, Inc. | $240 |
| Abbott Laboratories | $140 |
| Alexion Pharmaceuticals, Inc. | $129 |
| Neurocrine BioSciences Inc. | $121 |
| Axsome Therapeutics, Inc. | $121 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-01-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190417002677 | I | Nurse Practitioner | AL | TBD |
| I20200124001776 | I | Nurse Practitioner | CA | TBD |
| I20220118002506 | I | Nurse Practitioner | NY | TBD |
| I20220118002746 | I | Nurse Practitioner | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 20 | 15 | $0 |
Insurance plans in this area (ZIP 35127)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | PA | |
| Gastroenterology, Internal Medicine | NY | |
| Internal Medicine | NY | |
| Orthopedic Surgery | NY | |
| Vascular Surgery, General Surgery | NY | |
| Pediatric Medicine, Internal Medicine | NY | |
| Radiation Oncology | NY | |
| Nephrology, Internal Medicine | NY | |
| A N E S T H E S I O L O G Y | FL | |
| A N E S T H E S I O L O G Y | NY |
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