NELLDA C CLARK (CRNP) – Acute Care Nurse Practitioner, NPI 1407853880
Acute Care Nurse Practitioner
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 NELLDA C CLARK (CRNP)
440, Taylor Road, Mitylene, Montgomery, Montgomery County, Alabama, 36117, United States
3230
MONTGOMERY, AL 361173588
Phone: (334) 265-7075
Fax: (334) 261-6113
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 46 Open Payments records for all available years, with a total value of $919.
Total Amount is formed as General ($919) + Research ($0) + Ownership ($0) = $919.
Last reported payment date: 2024-12-02 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($252).
Total Amount
$919
General + Research + Ownership
Payments
46
Total payment records
General Amount
$919
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-02
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2008-05-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20080513000036 | I | Nurse Practitioner | AL | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 158 | 141 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 108 | 91 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 62 | 56 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 36117)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology) | AL | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL | |
| R H E U M A T O L O G Y | IL | |
| Family Practice, Emergency Medicine | AL | |
| Nurse Practitioner | AL | |
| H O S P I T A L I S T | IL | |
| Vascular Surgery, General Surgery | AL | |
| General Surgery | AL | |
| Family Practice | GA |
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