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KRISTEN CLARK
NPI 1124902309
Nurse Practitioner - Family in Okatie, SC

Active since August 01, 2025PECOS Enrolled
122 OKATIE CENTER BLVD N STE 240, OKATIE, SC 29909(843) 832-7925 Get Directions Write a Review

NPPES record last updated: August 1, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kristen Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTEN CLARK (NPI 1124902309) is an individual family provider in Okatie, South Carolina, licensed in South Carolina (30794) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1124902309
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKRISTEN CLARK
Location Address122 OKATIE CENTER BLVD N STE 240Okatie, SC 29909-3782
Mailing Address9 Chestnut StBeaufort, SC 29906-2414 · (803) 508-3043
Phone(843) 832-7925
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 1, 2025
NPPES CertifiedAugust 1, 2025
✔ NPI 1124902309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in SC · 30794
122 OKATIE CENTER BLVD N STE 240, Okatie, SC 29909
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kristen Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6204319734
PECOS Enrollment IDI20260312003879
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kristen Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Coastal Neurology, P.A.
16 mi
Neurology
1833 N. PARIS AVENUE
Port Royal, SC 29935
  • Reassigned Medicare billing, South Carolina enrollment
  • 4 clinicians in this Medicare group
NPI 1750346789 (843) 522-1420

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29909 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristen Clark's NPI number?

The NPI number for Kristen Clark is 1124902309. It was assigned to this individual provider in the NPPES registry on August 1, 2025.

Where is Kristen Clark located?

Kristen Clark practices at 122 Okatie Center Blvd N Ste 240, Okatie, SC 29909. The listed phone number is (843) 832-7925.

What is Kristen Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kristen Clark enrolled in Medicare?

Yes. Kristen Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kristen Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristen Clark reassigns Medicare benefits to Coastal Neurology, P.A. (Port Royal, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kristen Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kristen Clark accept?

Health plans from BlueCross BlueShield of South Carolina list Kristen Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kristen Clark was last updated on August 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.