DONALD LEE III CLARK (FNP-BC) – Family Nurse Practitioner, NPI 1366090573
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
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Provider Addresses for DONALD LEE III CLARK (FNP-BC)
8308, Burlington Drive, Troy, Madison County, Illinois, 62294, United States
TROY, IL 622944003
Phone: (618) 402-3946
Type: Mailing
Gateway Regional Medical Center, 2100, Madison Avenue, Granite City, Madison County, Illinois, 62040, United States
GRANITE CITY, IL 620404713
Phone: (618) 798-3000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $45.
Total Amount is formed as General ($45) + Research ($0) + Ownership ($0) = $45.
Last reported payment date: 2024-05-07 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($45).
Total Amount
$45
General + Research + Ownership
Payments
2
Total payment records
General Amount
$45
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $45 |
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: 2019-10-29
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 |
|---|---|---|---|---|
| I20191029000651 | I | Nurse Practitioner | IL | 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 |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 13 | 13 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 11 | 11 | $0 |
Insurance plans in this area (ZIP 62294)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | ME | |
| - | IL | |
| Nurse Practitioner | IN | |
| Internal Medicine, Hospitalist | IL | |
| Nurse Practitioner | IL | |
| Emergency Medicine | IN |
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