JENNIE S CLARK (PA C) – Surgical Physician Assistant, NPI 1114910247
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,118 PHYSICIAN ASSISTANT in TN
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Provider Addresses for JENNIE S CLARK (PA C)
Alcoa Highway, Topside, Knoxville, Knox County, Tennessee, 37920, United States
SUITE E 180
KNOXVILLE, TN 379202244
Phone: (865) 305-6955
Fax: (865) 637-5216
Type: Location
PO BOX 440547
NASHVILLE, TN 372440547
Phone: (865) 670-6199
Fax: (865) 670-6188
Type: Mailing
1940 ALCOA HWY STE E260
KNOXVILLE, TN 379202266
Phone: (865) 305-6955
Fax: (865) 305-8238
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 75 Open Payments records for all available years, with a total value of $2,197.
Total Amount is formed as General ($2,197) + Research ($0) + Ownership ($0) = $2,197.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($396).
Total Amount
$2,197
General + Research + Ownership
Payments
75
Total payment records
General Amount
$2,197
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
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: 2004-06-07
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 |
|---|---|---|---|---|
| I20040607001475 | I | Physician Assistant | TN | 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 |
|---|---|---|---|---|
| 33533 | Coronary artery bypass using artery graft, 1 graft | 20 | 20 | $0 |
| 33508 | Harvest of vein using an endoscope | 18 | 18 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 15 | 15 | $0 |
| 33518 | Coronary artery bypass using vein or artery graft, 2 grafts | 12 | 12 | $0 |
Insurance plans in this area (ZIP 37920)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | TN | 33518 | Combined multiple vein and artery heart artery bypasses | 13 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TN | |
| Certified Nurse Midwife (Cnm) | TN | |
| - | TN | |
| Surgical Oncology | TN | |
| - | SC | |
| - | TN | |
| - | TN | |
| - | TN | |
| - | TN | |
| - | TN |
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